Some men are finding a new purpose for the erectile dysfunction drug tadalafil (sold as Cialis) beyond extending their erections: They believe a daily dose of this pill could help them live longer.

This daily, long-acting ED pill can improve blood flow, and studies suggest it may also boost cardiovascular and cognitive health.

Why Is Tadalafil Linked to Longevity?

Phosphodiesterase 5 (PDE5) inhibitors, a class of drugs that includes tadalafil and Viagra (sildenafil), were originally studied for treating high blood pressure and cardiovascular disease. Researchers later discovered that PDE5 inhibitors offer benefits for ED, so manufacturers focused on this as the primary indication instead.

But researchers have continued to investigate whether PDE5 inhibitors could have other health benefits.

A 2025 observational study linked the use of tadalafil, the active ingredient in Cialis, to a 34% lower risk of death, a 27% lower risk of heart attack, a 34% lower risk of stroke, and a 32% lower risk of dementia. Longevity influencer Bryan Johnson cited these findings in a social media post explaining why he takes 5 milligrams (mg) of tadalafil daily.

“Other studies found somewhere around a 44% to 55% lower risk of death or heart-related death. Those numbers sound huge, and I get why Bryan Johnson and others latched onto them,” Martin Gross, MD, a urologist specializing in sexual medicine and reproductive health at Yale New Haven Health and associate professor of urology at Yale School of Medicine, who was not involved in the study, told Verywell in an email.

However, these studies were observational, meaning researchers looked for patterns in existing health data. They were not clinical trials where researchers randomly assigned people to take tadalafil or a placebo, so the findings cannot prove that the drug can reduce the risk of heart attacks, dementia, or early death, Gross said.

Cialis (tadalafil) vs. Viagra (sildenafil)

The 2025 study linked both tadalafil and sildenafil to longevity benefits, but the association was stronger for tadalafil.

One possible explanation is how long the drugs stay in the body. Tadalafil can remain active for up to 36 hours, compared with about four to five hours for sildenafil.

“Because it helps keep blood vessels relaxed for a longer period of time, tadalafil may improve blood flow throughout the body, including the heart, brain, and the body’s smallest blood vessels. It may also reduce the tendency of platelets to form clots and lessen cell damage caused by harmful oxygen molecules, known as oxidative stress. Together, these effects could potentially help protect the heart and other organs,” said Dietrich Jehle, MD, first author of the study and program director, professor, and chair of the Department of Emergency Medicine at the University of Texas Medical Branch in Galveston, Texas.

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Men Who Take Cialis Are Often Already Healthier

The observational studies also have another important limitation: healthy-user bias. Someone who takes tadalafil is different from people who don’t.

“He’s sexually active, he has a partner, he’s engaged with the healthcare system, he showed up for a visit and asked for something. Those are all independently associated with living longer,” Nelson E. Bennett Jr., MD, a professor of urology at Northwestern University Feinberg School of Medicine, in Chicago, told Verywell in an email.

The bigger longevity benefit may have less to do with the ED drug itself and more to do with being proactive about doctor’s visits. ED is often an early sign of cardiovascular disease, so identifying and treating this can keep someone healthier for longer.

“The penis is a vascular organ with small arteries, so it fails early. A man in his 40s with new ED and no obvious cause deserves a cardiometabolic workup, not just a prescription. That’s the real longevity intervention hiding inside this conversation,” Bennett said.

Potential Side Effects of Tadalafil

Despite the lack of randomized controlled trials, online marketplaces and telehealth platforms provide tadalafil prescriptions to both men and women for longevity.

“None of this research includes women, even though some of these clinics are marketing tadalafil to them, too, for reasons it isn’t approved for. We simply don’t have safety data there,” Gross said. 

It is risky to combine certain medications, especially nitrates, with tadalafil because your blood pressure may drop too low.

“If you’re curious, talk to your own doctor, someone who knows your actual health risks and your medication list, not an online form built to sell you a subscription. And if you’re already a good candidate for tadalafil for its approved use, the boring stuff—exercise, sleep, not smoking, keeping your blood pressure and cholesterol in check—is still doing more of the real work than the pill is,” Gross said.