Biomarkers we prioritize on this medication
Low testosterone is a common contributor to ED
View marker →Diabetes is the most common reversible ED driver
View marker →ED often precedes cardiovascular disease by years
View marker →A one-time read on inherited cardiovascular risk
View marker →Thyroid dysfunction in either direction affects erections
View marker →Relevant where urinary symptoms are part of the picture
View marker →Vasodilation causes hypotension
View marker →If there is kidney impairment, drug levels can rise in body
View marker →Direction is how the marker usually moves on this class of medication, not a target set for you. Once you are prescribed, your own values, ranges and trend appear in the app.
Medicine information
Tadalafil is a long-acting PDE5 inhibitor that increases blood flow to support firm, lasting erections, with effects that can last up to 36 hours.
Commonly prescribed for
Active ingredients
Tadalafil
An oral tablet, either daily at a low dose or as needed at a higher dose. Store at room temperature. Effects from the as-needed dose can persist for up to 36 hours. Your prescriber selects which approach fits.
The most commonly reported effects are headache, indigestion, back pain, muscle aches, nasal congestion, flushing and limb pain. The back pain and muscle ache are characteristic of tadalafil and typically appear 12 to 24 hours after a dose, reflecting how long the medication stays in the body. Less commonly reported are low blood pressure and fainting, prolonged erection and priapism, and serious skin reactions including Stevens-Johnson syndrome. Rare but serious reported events include sudden loss of vision in one or both eyes from non-arteritic anterior ischaemic optic neuropathy, and sudden hearing loss. An erection lasting more than four hours, sudden vision loss or sudden hearing loss all require emergency care.
Tadalafil is not prescribed to anyone taking nitrates in any form, including nitroglycerin and amyl nitrite or "poppers"; because tadalafil lasts longer than other medications in its class, at least 48 hours must pass after a dose before a nitrate can be given even in an emergency. It is also not prescribed with guanylate cyclase stimulators such as riociguat, or to anyone with a serious allergy to tadalafil or any component of the tablet. It is not appropriate where sexual activity is inadvisable because of heart disease, and it is used cautiously with alpha-blockers, with left ventricular outflow obstruction, with severe liver or kidney impairment, with a history of NAION, and in conditions that predispose to priapism. Substantial alcohol and strong CYP3A4 inhibitors such as ketoconazole and ritonavir both increase the risk of a drop in blood pressure and change how it is dosed. Whether this medication is appropriate is a decision your prescriber makes from your history and your medicines.
Tadalafil selectively inhibits phosphodiesterase type 5 (PDE5), an enzyme that breaks down cyclic GMP in the smooth muscle of the penis. By blocking PDE5, tadalafil allows cGMP levels to remain elevated, relaxing smooth muscle and increasing blood flow into the penis during sexual stimulation. Its longer half-life compared to other PDE5 inhibitors is why its effects can last up to 36 hours.
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Frequently Asked Questions
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Your membership includes four targeted lab panels each year, continuous monitoring from the wearable device of your choice, and continuous monitoring of your smart scale to track weight and body composition. You’ll also receive access to our proprietary health scoring system, built on the American Heart Association’s Life’s Essential 8, which gives you a clear picture of your cardiovascular and metabolic health. Membership comes with ongoing support from a dedicated health coach, custom supplements, and access to prescription treatment through independent licensed providers, all managed directly through your dashboard. Additional devices and monitoring tools can be purchased at discounted member pricing.
OneTwenty is a health optimization membership, not a medical practice. We don't diagnose, treat, or cure medical conditions, and we don't practice medicine.
What we do is give you a clearer picture of your own health. Your membership includes quarterly lab testing, integration of your wearable data, and an AI-powered view of your biomarkers and trends over time. The focus is optimization and prevention for people who are generally healthy and want to stay that way, not the treatment of disease.
Anything clinical, including prescriptions, is delivered by independent, licensed healthcare providers through our telehealth partners. Those providers exercise their own medical judgment and are solely responsible for any evaluation, diagnosis, treatment, or prescription. OneTwenty does not direct or control their clinical decisions.
If you're managing a diagnosed condition, OneTwenty is not a substitute for your physician. We're a complement to the care you already receive, focused on helping you understand and improve the long-term inputs to your health.
Most members can use HSA or FSA funds for their OneTwenty membership. Your membership covers diagnostic lab testing and clinician review, which are generally eligible medical expenses, though final eligibility depends on your specific plan. If you pay with an HSA/FSA card, it works like any other card at checkout. If you don't have a card, or your plan requires documentation, we provide an itemized statement listing the services, the ordering provider, and the amount paid, which you submit to your plan administrator for reimbursement. We can't guarantee your plan's decision, so we recommend confirming with your administrator.
No, OneTwenty prioritizes natural interventions that escalate over time. We will start with lifestyle modifications, then supplements, and only then if needed do we prioritize medication intervention.
We are available in 49 states except for Rhode Island. In New York and New Jersey, there is an increased fee due to collection laws in place that don't allow us to use the Quest Network.
Your privacy and security are foundational to OneTwenty. We run on infrastructure and software built to HIPAA security standards, and we apply the same core safeguards used to protect data in regulated healthcare settings: encryption in transit and at rest, strict role-based access controls, and full audit logging of who accesses your information and when. We never sell your personal health data. You decide what you connect and share, and you can request deletion of your data at any time.
One year on the OneTwenty platform, which covers four lab draws: one comprehensive initial panel to set your baseline, and three custom follow-up panels based on your results. Any additional services are available separately at transparent pricing.
Currently, we do not support direct insurance billing for lab orders. We made this decision to protect our members from unexpected and excessive costs.
Here is why:
The "Medical Necessity" Requirement: Insurance companies typically only cover lab tests that are tied to a specific illness or diagnosis code (ICD-10). Because many of our panels are proactive and focused on longevity (preventive wellness) rather than treating an active sickness, they are frequently rejected by insurers as "investigational" or "not medically necessary."
The Cost Risk: If we submitted these orders to your insurance and they were denied, the lab would bill you their standard "retail price." This retail price can be 5x to 10x higher than the negotiated rates we have secured for you.
Our Solution: By operating on a self-pay basis, we guarantee you access to our heavily discounted wholesale rates, ensuring you know exactly what you are paying upfront with no surprise bills in the mail later.
We are working on it: We understand that using insurance is preferred for basic labs. We are actively working on a solution that will allow us to safely bill insurance for standard preventive tests while keeping advanced longevity markers separate. We hope to introduce this hybrid option in the future.
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