Vidalista 60 is marketed as a 60 mg tadalafil product, but this is important: standard prescribing information for tadalafil used for erectile dysfunction recommends 5–20 mg, with 20 mg generally the maximum on-demand dose. Long-term studies have therefore not established the safety of 60 mg. For higher-than-recommended doses such as 60 mg, areas where long-term safety remains uncertain include: Cardiovascular effects: prolonged blood-pressure lowering and potential effects in people with underlying cardiovascular disease. Vision and hearing: rare serious visual or auditory events have been reported with PDE5 inhibitors, Vidalista 60 a direct causal relationship is not always established. Kidney and liver effects: long-term studies at approved doses have not shown clinically meaningful kidney or liver toxicity, but evidence cannot be extrapolated confidently to chronic 60 mg exposure. Persistent adverse effects: headache, indigestion, back pain, muscle aches, flushing, and nasal congestion can occur, with greater exposure potentially increasing side-effect risk. Long-term efficacy and tolerance: studies support tadalafil use for up to 18–24 months at 5–20 mg, but comparable long-term evidence for 60 mg is lacking. Bottom line: the major unanswered question is not whether tadalafil itself can be used long term—it can at approved doses—but whether 60 mg provides an acceptable long-term safety margin. There isn't sufficient clinical evidence to establish that.