João, 27 years old, has always been healthy and works out at the gym five times a week. On social media, he saw an influencer claiming that a tadalafil tablet before training would make muscles "more pumped" and the workout "more intense". Without a prescription, without an examination, without speaking to any doctor, he bought the medication and started using it before training. Weeks later, in the middle of a squat set, he felt severe dizziness, blurred vision and almost fainted.

Stories like this have become increasingly common in Brazilian gyms. And that's what we're going to talk about today.

"The data and clinical case cited in this article are fictitious and are merely illustrative, serving to facilitate understanding of the topic addressed."

What is tadalafil and what is it used for

Tadalafil is the medication popularly known as the "erectile dysfunction pill", also sold under other brand names. It was created to treat erectile dysfunction, enlarged prostate in older men and, in very specific cases, a type of high blood pressure that affects the lungs.

Simply put: this medication relaxes the walls of blood vessels, causing them to open a little more and allow more blood to pass through. That's why it works for erections. And it's precisely this "vessel-opening" effect that gave rise to the idea, with no evidence whatsoever, that it could also help with training.

Why people started using it as a pre-workout

The idea behind this trend is simple, but wrong: because the medication opens blood vessels, many people imagined that it would also increase blood flow to the muscles during training, giving the body that more "full" and pumped appearance, the famous pump. This effect on appearance, combined with the rush for quick results and pressure for a perfect body on social media, caused healthy young people and adults, with no erectile problems, to start taking the medication on their own.

The growth in sales reinforces the trend. Anvisa data shows a sharp increase in medication sales between 2024 and 2025, with double-digit growth in just one year. A significant portion of this consumption comes from people with no clinical indication for the medication.

What science really says about physical performance

Here is the most important point of this text: there is no scientific proof that tadalafil makes you stronger, gives you more stamina or builds more muscle. Studies conducted with healthy people found no real improvement in training with the use of the medication before exercise. That "pump" sensation some people feel is just temporary swelling from blood vessel dilation, not real gain.

In other words: the supposed benefit is just appearance, it doesn't last long, and it comes with real risks that wouldn't exist if the medication were used correctly, with a doctor's recommendation and monitoring.

The real risks of using tadalafil as a pre-workout

Taking a medication that opens blood vessels during intense training, without any medical evaluation, puts the body at real risk. Here's what can happen:

  • Drop in blood pressure: can cause dizziness, feeling faint or even actual fainting, which is even more dangerous in the middle of intense exercise.
  • Rapid and strained heartbeat: to compensate for the drop in blood pressure, the heart needs to work faster, just when it's already straining because of the training.
  • Vision problems: blurred vision or light sensitivity, which is also dangerous when you're holding weights.
  • Chest pain: a serious warning sign. If this happens, you need to seek medical attention immediately.
  • Erection that doesn't go away (priapism): when an erection lasts more than four hours and doesn't go away on its own, it's a medical emergency. If not treated quickly, it can cause permanent damage.
  • Dangerous combination with other medications: mixing tadalafil with chest pain medications (nitrates) can cause a sudden and dangerous drop in blood pressure. It can also interact poorly with blood pressure medications, anti-inflammatories and some antibiotics.

People with serious heart problems, who have recently had a heart attack or stroke, or who already take chest pain medication, cannot use tadalafil at all. This shows why this decision should never be made alone, without a doctor evaluating the case.

Who can actually use tadalafil

Tadalafil is a safe medication when used correctly, and this depends on an individual evaluation by a doctor. It can be indicated, for example, for men with erectile dysfunction or enlarged prostate, always after a consultation, with their health history analysed and the correct dose for each person. The problem isn't the medication itself, it's using it on your own, copying what you see on the internet, without knowing if your body is prepared for it.

What to use as pre-workout in a healthy way

If the idea is to train with more energy and focus, there are simple and proven ways to do this, without putting your health at risk:

  • Caffeine, in the right amount, is one of the most studied substances for providing more energy and motivation during training.
  • Beetroot and dark leafy greens have a natural effect similar to opening blood vessels, and help with performance during exercise.
  • Drinking plenty of water before, during and after training.
  • Eating well before training, with carbohydrates for energy and protein to help the muscle.
  • Getting enough sleep, something many people forget about, but which makes all the difference in performance and body recovery.

These choices deliver much of the effect that people are looking for, without the risks of taking a medication that shouldn't be used this way.

When to seek medical guidance

If you already use or are thinking of using tadalafil as a pre-workout, or if you've already felt dizziness, chest pain, visual changes or any discomfort after use, the right path is to speak with a doctor before making any decision. A telemedicine consultation allows evaluation of your health history, identification of contraindications and guidance on the best way to achieve your training goals safely, without relying on internet fads.

This content is exclusively informative in nature and does not replace medical consultation. Do not use any medication on your own, especially for purposes other than those approved in the package insert. Always seek guidance from a healthcare professional before starting, stopping or changing any treatment.

Dr. Rebeca Soares Andrade CRM - GO 39335