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Sexual health · Kaunas

Tadalafil 10/20mg in Kaunas, online

An EU-licensed doctor reviews your case and, if eligible, issues an electronic prescription you can collect at a pharmacy in Kaunas.

€35once

Consultation price. The medicine is paid at your pharmacy.

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  • Collect at any EU pharmacy
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Tadalafil 10/20mg

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Valid across the EU

E-prescription accepted at EU pharmacies.

Local facts

Tadalafil 10/20mg consultations in Kaunas

Available toResidents of Lithuania
LanguagesSpanish and English
Doctor replyUnder 2 hours on average
Collected atPharmacies in Lithuania · e-prescription (PDF)
About the medicine

What it is and how it works

Tadalafil is a PDE5 inhibitor whose long half-life sets it apart: up to 36 hours of therapeutic window. That allows spontaneity, and a low-dose daily regimen is available for continuous use when clinically appropriate.

It also suits people who respond better to sustained action, and it's considered in cases with lower urinary tract symptoms (BPH), where tadalafil is indicated. The doctor weighs the on-demand versus daily approach with you.

Who it is for

  • Adult men with erectile dysfunction; a daily dose also eases prostate symptoms
  • One tablet at least 30 minutes before sex, or a low dose once every day

Safety summary

Nitrates and poppers are contraindicated: blood pressure can fall dangerously

Read the safety summary
Pricing

One consultation, one clear price

You pay for the doctor's consultation. If a prescription is issued, the medicine is paid at your own pharmacy.

  • Consultation reviewed by an EU-licensed doctor
  • Private follow-up in the in-app chat
  • Full refund if the doctor does not approve
One-off

Sexual health

One-offNo subscription€35once
  • Consultation reviewed by an EU-licensed doctor
  • Electronic prescription if approved
  • Private follow-up chat
Start consultation

Full refund if a review is not approved

FAQs

Your questions answered

Tadalafil 10/20mg16 questions
What makes tadalafil unique among PDE5s?
Its long half-life: up to 36 hours of therapeutic window. It allows spontaneity and a low-dose daily regimen is available for continuous use when clinically appropriate.
The on-demand dose acts in 30–60 minutes. The low daily dose (typically 5 mg) reaches steady state in a few days and allows sexual activity without planning.
More questions
Those seeking more spontaneity, or those who respond better to sustained action. It is also considered in cases with lower urinary tract symptoms (BPH), where tadalafil is indicated.
Mild back pain, muscle ache, headache and facial flushing. Usually transient. Any visual disturbance or prolonged erection (>4 h) requires immediate medical attention.
Up to about 36 hours from a single on-demand dose. Three at-home studies in 1,054 men found statistically significant improvement in erectile function and in the ability to have successful intercourse up to 36 hours after dosing, and an effect as early as 16 minutes. A separate trial in 348 men measured 59.2% of intercourse attempts successful at the 36-hour mark, against 28.3% on placebo. The long window comes from a half-life of 17.5 hours, which is far longer than the other tablets in this class. Lasting 36 hours does not mean 36 hours of erection, only that the tablet is still working if arousal happens.
That is a prescriber decision, and it mostly turns on how often you expect to have sex. The EU product information says a once-daily regimen at the lowest doses may be considered suitable for men who anticipate frequent use, meaning at least twice weekly, based on patient choice and the physician's judgement. The recommended daily dose is 5 mg at roughly the same time each day, which can be reduced to 2.5 mg if tolerance is an issue. The advantage is that dosing and sex are no longer linked. On-demand 10 mg or 20 mg suits less frequent, more planned activity.
Food does not meaningfully change it. The EU product information states that the rate and extent of absorption of tadalafil are not influenced by food, so it can be taken with or without a meal. This is a real difference from sildenafil, where food reduces the rate of absorption with a mean delay in peak levels of 60 minutes and a mean 29% reduction in peak concentration. Alcohol is different again. Tadalafil did not increase the average blood-pressure drop from alcohol, but some people experienced postural dizziness and low blood pressure on standing, and heavy drinking makes erections harder to achieve.
Write to your doctor in the private chat in your account: describe what you notice and when it started. The doctor can adjust the plan, pause it or suggest another option. If you have severe symptoms such as difficulty breathing, swelling of the face or chest pain, call 112 or go to an emergency department straight away.
It depends on what you take. List every medicine, supplement and herbal product in the questionnaire, including ones you use only occasionally. The doctor checks for interactions before prescribing, and your pharmacist checks again when you collect Tadalafil 10/20mg.
Depending on your case, the doctor can consider a different medicine or dosing pattern, or recommend an in-person urologist, a sexual health clinic or psychosexual therapy. If a heart condition or another health issue needs checking first, the doctor tells you before prescribing anything.
If the medicine does not work as expected or causes side effects, write to your doctor in the private chat. The doctor can review the dose or the option chosen. Tell the doctor about any new health condition or new medicine before you use it again.
Yes. Hi-Doctor runs 100 % online across the EU, so if you live in Kaunas you can fill in the questionnaire and receive the medical review without travelling. The electronic prescription issued by the licensed doctor is valid in any EU pharmacy under Directive 2011/24/EU; outside Spain, the pharmacist dispenses the locally marketed equivalent of the same active ingredient.
Yes. All communication happens in the private chat of your account, GDPR-compliant. The doctor treats discretion as a core of the service and there is no history visible outside your consultation.
The private electronic prescription (Receta Médica Privada Electrónica) is issued by a licensed doctor in Spain. It is a PDF carrying every field required by EU Directive 2011/24/EU (patient, prescriber with country of registration, active ingredient, dose), which makes it legally recognised across all 27 EU member states. In Spanish pharmacies it is dispensed from the QR; outside Spain, the pharmacist dispenses the locally marketed equivalent of the same active ingredient.
1) Fill in an online medical questionnaire in about 4 minutes. 2) The plan is €25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth; sexual health is €35 per consultation and a skin consultation is €40. 3) An EU-licensed doctor reviews your case and, if appropriate, issues an electronic prescription. 4) Collect it at any EU pharmacy. If the review is not approved, the applicable fee is refunded in full.
The plan is €25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth; a one-off sexual-health consultation is €35 and a skin consultation covering acne, rosacea, melasma and ageing skin is €40. Each includes a licensed doctor's review and an electronic prescription if approved. If the review is not approved, the applicable fee is refunded in full. Medication is paid for separately at the pharmacy at the price it sets.
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How your doctor decides

Your answers

A licensed doctor reads your full questionnaire.

Medical judgement

The decision is clinical, never an algorithm.

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Approved with an e-prescription, or refunded in full.

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Medicine information and safety

How does Tadalafil 10/20mg work?

Arousal releases nitric oxide. Sexual stimulation is what starts the process. Nerves and the lining of the blood vessels in the penis release nitric oxide, which triggers a messenger chemical called cyclic guanosine monophosphate, usually shortened to cGMP. Without arousal, tadalafil does nothing at all.

Tadalafil blocks the PDE5 enzyme. Tadalafil is a selective, reversible blocker of an enzyme called phosphodiesterase type 5, or PDE5, whose normal job is to break cGMP back down. With PDE5 blocked, cGMP builds up in the erectile tissue instead of being cleared away as fast as it appears.

Blood flows in, erection follows. Higher cGMP relaxes the smooth muscle in the arteries of the corpus cavernosum, so blood flows into the penis and an erection can form. The same relaxation happens in the prostate and bladder, which is why a daily dose can also ease urinary symptoms.

How to use Tadalafil 10/20mg

Agree which regimen first. There are two routes. On demand means one tablet before sex. Once daily means a small tablet every day, so dosing and sex are no longer linked. Your prescriber chooses with you, mainly based on how often sex is expected.

Take it 30 minutes ahead. On the on-demand route, swallow the tablet whole at least 30 minutes before sexual activity. Peak blood levels are reached at around two hours. Never take more than one dose in any 24-hour period.

Food does not matter. Tadalafil can be taken with or without food, because the rate and extent of absorption are not influenced by meals. Dosing in the morning versus the evening also makes no clinically relevant difference to absorption.

Arousal is still required. The tablet does not produce an erection on its own. Sexual stimulation is required for it to work. If nothing happens without arousal, that is expected behaviour rather than a sign the dose is too low.

Same time each day if daily. On the once-daily route, take the tablet at roughly the same time every day. Steady levels in the blood are reached within five days of daily dosing, so judge the effect after that point, not on day one.

Go easy on alcohol. Tadalafil did not increase the average blood-pressure drop caused by alcohol in studies, but some people had postural dizziness and a drop in blood pressure on standing. Heavy drinking also makes erections harder to achieve.

List everything else you take. Grapefruit juice and medicines such as ritonavir, ketoconazole, itraconazole, erythromycin and clarithromycin raise tadalafil levels. Rifampicin, phenytoin and carbamazepine lower them. Include recreational drugs, especially poppers.

Keep the review booked. Whether continued daily use still suits you should be reassessed periodically. Report side effects, and tell any doctor treating you for chest pain that you take tadalafil, before nitrates are given.

Common side effects

Stop and get urgent medical help if (seek medical help immediately): An erection lasting four hours or more, which is a medical emergency, Sudden loss of vision, blurred vision or visual distortion in either eye, Sudden decrease or loss of hearing, with or without ringing in the ears, Chest pain during or after sex, and tell staff you have taken tadalafil, Swelling of the face, lips, tongue or throat, or difficulty breathing, Fainting, a seizure, sudden weakness or slurred speech, A severe rash that blisters or peels

Common (common (≥1/100 to <1/10)): Headache, the most frequently reported effect, usually mild and short-lived, Indigestion or heartburn, known medically as dyspepsia, Back pain, Muscle aches, known medically as myalgia, Pain in an arm or a leg, Flushing, a warm red feeling in the face and neck, A blocked or stuffy nose, On daily dosing most headaches appear in the first 10 to 30 days

Uncommon (uncommon (≥1/1,000 to <1/100)): Dizziness, Blurred vision, or sensations described as eye pain, Ringing in the ears, known medically as tinnitus, A fast heartbeat, or palpitations, Low blood pressure, or raised blood pressure, Shortness of breath, or nosebleeds, Abdominal pain, nausea, vomiting or acid reflux, Skin rash, prolonged erections, or blood in the urine

Rare (rare (≥1/10,000 to <1/1,000)): Stroke, transient ischaemic attack, fainting, seizures or transient amnesia, Migraine, Non-arteritic anterior ischaemic optic neuropathy, a sudden optic nerve injury, Visual field defect, swollen eyelids, red eyes or retinal vascular occlusion, Sudden hearing loss, Heart attack, unstable angina or ventricular arrhythmia, Priapism, penile bleeding or blood in the semen, Hives, Stevens-Johnson syndrome, exfoliative dermatitis or heavy sweating

Do not use Tadalafil 10/20mg if

  • You are allergic to tadalafil or to any other ingredient in the tablet
  • You take any form of organic nitrate, such as a nitroglycerin spray or tablet
  • You use riociguat or another guanylate cyclase stimulator
  • You use amyl nitrite or nitrate poppers, including recreationally
  • You are already taking another PDE5 inhibitor, because of severe low blood pressure and priapism risk
  • Your doctor has advised that sexual activity is inadvisable for your heart
  • You had a heart attack within the last 90 days, or a stroke within the last 6 months
  • You have unstable angina, or angina that comes on during sexual intercourse
  • You have had New York Heart Association class 2 or worse heart failure in the last 6 months
  • You have uncontrolled arrhythmia, uncontrolled high blood pressure, blood pressure below 90/50 mmHg, or past vision loss in one eye from NAION

Medicines and substances that interact

  • Nitrates (e.g. GTN spray, isosorbide): Tadalafil amplifies the blood-pressure drop from nitrates, which can be large and unpredictable Absolute bar to prescribing; at least 48 hours must pass before emergency nitrates
  • Riociguat and other guanylate cyclase stimulators: Adds to the blood-pressure-lowering effect and can cause symptomatic low blood pressure Contraindicated, so the prescriber selects a different treatment entirely
  • Doxazosin (an alpha-blocker): Significantly increases doxazosin's blood-pressure drop for at least twelve hours, sometimes causing fainting Combination not recommended; prescriber may change the alpha-blocker or avoid tadalafil
  • Other alpha-blockers (alfuzosin, tamsulosin): Both are blood-vessel relaxants, so blood pressure can fall further, especially in older men Start at the minimum dose and adjust gradually, with extra caution in the elderly
  • Ritonavir, ketoconazole, itraconazole, erythromycin, grapefruit juice: Block the CYP3A4 enzyme; ketoconazole 400 mg daily quadrupled tadalafil exposure in a study Prescribe with caution, and a lower tadalafil dose may be chosen
  • Rifampicin, phenytoin, carbamazepine, phenobarbital: Speed up tadalafil breakdown; rifampicin cut tadalafil exposure by 88% in a study Expect a weaker effect; the prescriber reviews whether tadalafil still suits you
  • Blood-pressure medicines (ACE inhibitors, beta-blockers, diuretics, calcium blockers): A small extra fall in blood pressure, generally minor and not likely to be clinically relevant Usually allowed, with advice about dizziness and a possible review of doses
  • Other erectile dysfunction treatments: Combining tadalafil with other ED treatments has not been studied for safety or effectiveness Do not combine; the prescriber keeps you on one treatment at a time

References

  1. Cialis (tadalafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2025
  2. Cialis: EPAR medicine overview European Medicines Agency, 2002
  3. Cialis 20 mg film-coated tablets: Summary of Product Characteristics electronic medicines compendium (emc), 2026
  4. Tadalafil: NHS medicines A to Z National Health Service (UK), 2026
  5. Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses The Journal of Urology 168(4 Pt 1):1332-6, 2002
  6. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial Urology 62(1):121-5, 2003
  7. EAU Guidelines on Sexual and Reproductive Health, limited update March 2025 European Association of Urology, 2025
  8. Viagra (sildenafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2025
  9. Levitra (vardenafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2024
  10. Spedra (avanafil): Summary of Product Characteristics, Annex I European Medicines Agency, 2025
  11. Tadalafilo: authorised medicines register (99 entries, prescription-only) AEMPS CIMA, Spain, 2026
  12. CIALIS 20 mg comprimé pelliculé: liste I, non remboursable, prix libre Base de données publique des médicaments, France, 2026
  13. § 34 SGB V: medicines excluded from statutory health insurance, including erectile dysfunction Bundesministerium der Justiz, Germany, 2026
  14. Nota 75: PDE5 inhibitor reimbursement limited to neurogenic erectile dysfunction AIFA, Gazzetta Ufficiale della Repubblica Italiana n. 7, 2017
  15. Tadalafil: not reimbursed by basic health insurance Medicijnkosten.nl, Zorginstituut Nederland, 2026
  16. Lista de medicamentos genéricos disponíveis no mercado: tadalafil, taxa de comparticipação 0% INFARMED, Portugal, 2026
  17. Public assessment report: Cialis for men 10 mg film-coated tablets, a non-prescription tadalafil medicine Health Products Regulatory Authority, Ireland, 2024
  18. Tadalafil Mensil 10 mg: availability category OTC, medicine supplied without a doctor's prescription Rejestr Produktów Leczniczych, Poland, 2026
  19. Tadalafil 5 mg oral tablet: Cialis and seven generics listed under erectile dysfunction CBIP/BCFI Répertoire Commenté des Médicaments, Belgium, 2026
  20. Arzneispezialitätenregister: authorised medicines register BASG, Austria, 2026

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All content on this page has been medically reviewed by: Dr. Alejandro Infante, General medicine, on 27 July 2026. Registration: 080869277 View profile

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