Once-daily tadalafil,
does it really help with Increased recovery of unassisted erectile function after treatment cessation?
research showsThe grade is D with 28 points. In the 422-person treated REACTT analysis, IIEF-EF at least 22 after nine months of treatment and a six-week drug-free washout occurred in 20.9% with once-daily tadalafil and 19.1% with placebo, OR 1.1 (95% CI 0.6 to 2.1, P=0.675). Erectile function improved while taking the drug, but the prespecified primary claim of unassisted recovery after stopping was null.
ads claimAn erection benefit while taking tadalafil and natural recovery after stopping are different questions. An on-drug secondary result should not be marketed as proof that nerves were rehabilitated.
Useful facts when choosing a product
- REACTT used nine months of blinded treatment, six weeks fully off drug, then a three-month open extension.
- All three selected papers report the same NCT01026818 trial.
- The registry sponsor and reported funder were Eli Lilly and Company.
What the research actually shows
Four hundred twenty-three participants were assigned to once daily, 139, on demand, 143, or placebo, 141. One on-demand participant never received study drug, leaving 422 analyzed. After washout, IIEF-EF at least 22 occurred in 20.9%, 16.9%, and 19.1%, respectively. Odds ratios versus placebo were 1.1 (0.6 to 2.1) for daily and 0.9 (0.5 to 1.7) for on demand. The three reports divided main, time-to-recovery, and quality-of-life or satisfaction outcomes from the same REACTT trial; all use NCT01026818 and are not three replications. Eli Lilly funded the trial and employees were coauthors. Randomization, double masking, and double dummy were reported, but the public material reviewed did not establish the implementation method for allocation concealment, so the trial was not treated as defect-free.
Why this is classified as D (28)
The primary unassisted-recovery outcome was null, multiple papers were only reports of one manufacturer trial, and the confidence interval left substantial benefit possible, giving D with 28 points.
Counterpoint. Concomitant nitrates can cause dangerous hypotension, and cardiovascular status, antihypertensive therapy, and surgical recovery require urologic supervision.
Rejudgment record. Cross-check applied — Cross-checked the main REACTT report, two secondary reports, and NCT01026818 for single-trial identity, the post-washout primary outcome, treated denominator, on-drug secondary result, and Lilly funding
| Endpoint | P | Patient-reported treatment goal - the symptom is the goal |
| Replication | R1 | Single confirmatory trial |
| Independence | I0 | Evidence comes only from manufacturer studies |
| Effect size | E0 | Null |
| Precision | C0 | The confidence interval leaves room for benefit |
The scoring table and the verdict agree (D).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Unassisted erectile-function recovery after withdrawal | D | Once daily versus placebo gave OR 1.1 (0.6 to 2.1). |
| Improved erectile function during nine months on treatment | C | Once-daily treatment gave OR 2.2 (1.2 to 4.0), but this was a secondary on-drug result from one manufacturer trial. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | International multicenter three-arm randomized double-blind double-dummy phase IV trial | 141 | Funded and sponsored by Eli Lilly and Company, with company employees among the authors | Unassisted recovery to IIEF-EF at least 22 after nine months of treatment and six-week washout | Once daily 20.9%, on demand 16.9%, placebo 19.1%; daily versus placebo OR 1.1 (95% CI 0.6 to 2.1), P=0.675 | Multiple reports combined as one null manufacturer-funded trial |
Receipt — 3 References
All 3 cited sources were verified for existence at the original page (as of 2026-08-15).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-15 · Corrections: none
Cite this verdict
[Chamgap] Once-daily tadalafil x natural erectile rehabilitation after prostatectomy — Evidence Grade D·28. 3 cited sources checked. Source: https://chamgap.com/en/verdicts/mens/daily-tadalafil-post-prostatectomy-unassisted-erectile-rehabilitation/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.