Cialis – Uses, Side Effects, and More

Bremelanotide (Vyleesi) is an injectable medication that works on an area of your brain to improve sexual desire. This drug is also known as PT-141. Another medication used to treat low sex drive in women is the pill flibanserin (Addyi).

Cialis (tadalafil)

Cialis is a brand-name prescription medication. It’s FDA-approved to treat the following in men:

• erectile dysfunction (ED), a condition in which you can’t get or keep an erection
• symptoms of benign prostatic hyperplasia (BPH), a prostate condition that may cause problems with urination
• ED and symptoms of BPH together

Cialis comes as a tablet that you swallow. It’s available in four strengths: 2.5 mg, 5 mg, 10 mg, 20 mg. Depending on your situation and what condition Cialis is treating, you’ll take the drug either before sexual activity or once a day.

Cialis contains the active drug ingredient tadalafil and belongs to a group of medications called phosphodiesterase 5 (PDE5) inhibitors. For ED, Cialis relaxes the blood vessels leading to the penis so that more blood can flow into it. For BPH symptoms, Cialis relaxes muscles in your bladder, allowing you to urinate more easily.

Cialis is available only by prescription. It’s not available over the counter.

Effectiveness

For information on the effectiveness of Cialis in treating these conditions, please see the “Cialis uses” section below.

Cialis can work for up to 36 hours in your body.

To treat erectile dysfunction (ED), your doctor may have you take Cialis only as needed before sexual activity. (See the “Cialis dosage” section above to learn more.) In this case, Cialis may keep working for up to 36 hours in helping you have and maintain erections during that time.

However, if you take Cialis each day for either benign prostatic hyperplasia (BPH) or ED, you’ll always have medication in your system. Therefore, it will continue to work throughout the day.

The Food and Drug Administration (FDA) approves prescription drugs such as Cialis to treat certain conditions. Cialis may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Cialis for benign prostatic hyperplasia (BPH)

Cialis is approved by the FDA to treat the symptoms of benign prostatic hyperplasia.

BPH is a condition that occurs in men as they age. It happens when the prostate gland slowly increases in size but isn’t cancerous. As the prostate gland gets bigger, it begins to push on your bladder. So eventually you may experience symptoms of BPH, including:

• needing to urinate often, especially at night
• straining to urinate
• producing a weak stream of urine
• being unable to urinate
• feeling that your bladder didn’t empty after urinating

Effectiveness

Cialis was an effective medication to treat symptoms of BPH in clinical trials.

Researchers used a scale called the International Prostate Symptom Score (IPSS). IPSS is a questionnaire that was given to people to determine if their BPH symptoms improved. The symptoms included urinary urgency (sudden need to urinate), weak urine stream, and straining to urinate.

A higher score meant that symptoms of BPH were worse. The goal was to have a lower score, which indicates that people have had fewer and less severe symptoms of BPH.

The studies looked at people with BPH who took Cialis or a placebo (treatment with no active drug). Researchers found that people who took:

This means that the Cialis group noticed a larger decrease in the number and severity of BPH symptoms than the placebo group.

Cialis for erectile dysfunction (ED)

ED is a condition in which a man may have trouble having or maintaining an erection so they can have sex. There are many different causes of ED, including:

Sometimes ED can be helped by simply addressing the cause, such as treating an illness or anxiety. In other cases, you may need medication such as Cialis to treat your ED.

Effectiveness

Cialis was shown in clinical trials to be an effective medication to treat ED. The drug was studied using part of a survey called the International Index of Erectile Function (IIEF). A higher score on the IIEF meant that erectile function was better, so ED symptoms improved. The people in the study took the survey after 4 weeks.

One trial looked at people who took 20 mg of Cialis or a placebo only when needed to treat their ED.

• People who took Cialis had their IIEF scores improve by 6.9 to 9.3 points. This means that their ED symptoms eased while they were taking Cialis.
• People who took a placebo either lost points or improved by a maximum of only 0.3 points. Losing points on the scale means that their ED symptoms worsened.

In another trial, people took 2.5 mg or 5 mg of Cialis, or a placebo on an everyday basis to treat their ED.

• The study showed that for people who took any strength of Cialis, their IIEF scores improved by 6.1 to 9.7 points. This means that their ED symptoms eased while they were taking Cialis.
• In comparison, people who took a placebo had improvements of only 0.9 to 1.2 points.

Cialis for ED and BPH

Cialis is FDA-approved to treat both ED and the symptoms of BPH together. These are two different conditions and aren’t usually caused by the same issues. For details on ED and BPH, see the “Cialis for benign prostatic hyperplasia (BPH)” and “Cialis for erectile dysfunction (ED)” sections above.

In some cases, medications for BPH, such as dutasteride (Avodart), may cause a lower libido (sex drive) and result in ED. However, ED and BPH are common in aging males, and aren’t necessarily related.

Effectiveness

Cialis was an effective medication in clinical trials for people with both ED and BPH. The studies used two different questionnaires, one for ED symptoms and one for BPH symptoms, to determine how well the medication worked.

Measuring results for BPH symptoms

To measure improvement of BPH, researchers used a scale called the International Prostate Symptom Score (IPSS). IPSS is a questionnaire that was given to people to determine if their BPH symptoms improved. The symptoms included urinary urgency (sudden need to urinate), weak urine stream, and straining to urinate.

A higher score meant that symptoms of BPH were worse. The goal was to have a lower score, which indicates that people have had fewer and less severe symptoms of BPH.

• People with both ED and BPH who took Cialis had a decrease in their IPSS scores of 6.1 points.
• In comparison, people who took a placebo had a decrease in their score of about 3.8 points.

This means that, on average, people who took Cialis noticed a larger decrease in their BPH symptoms than people who took a placebo.

Measuring results for ED

To measure the improvement of ED symptoms, researchers used part of a survey called the International Index of Erectile Function (IIEF). People with both ED and BPH took the survey after 4 weeks. A higher score on the IIEF meant that erectile function was better, so ED symptoms improved.

• People who took Cialis had an increase in their IIEF scores of about 6.5 points.
• In comparison, people who took a placebo had an increase of only 1.9 points.

This means that people who took Cialis usually had greater erectile function than people who took a placebo.

Off-label use for Cialis

In addition to the uses listed above, Cialis may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. Below is an example of an off-label use for Cialis.

Cialis for ureteral stones

Cialis isn’t FDA-approved to treat ureteral stones. However, it may be used off-label for this purpose. A clinical trial compared Cialis with tamsulosin (Flomax), a drug that’s often used to treat ureteral stones. The study showed that more people who took Cialis were able to pass their stones than people who took tamsulosin.

Ureteral stones usually start out as kidney stones and then move into the ureter (the tube that urine travels in from the kidney to the bladder). Kidney stones are minerals that form a stone inside a kidney.

Cialis may work to treat ureteral stones by relaxing the ureter muscles. This makes the ureter wider, which can help you pass the stones more easily.

If you have questions about taking Cialis for ureteral stones, talk with your doctor.

Cialis is available as a generic drug called tadalafil. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

In some cases, the brand-name drug and the generic version may come in different forms and strengths.

The Cialis dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Cialis to treat
• your age
• other medical conditions you may have
• how often you’re taking Cialis

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

If you have certain conditions, such as kidney or liver problems, your doctor may have you start with a low dose of Cialis. This is done so that the medication doesn’t affect your other conditions.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths: 2.5 mg, 5 mg, 10 mg, 20 mg

Cialis comes as a tablet that you swallow. It’s available in four strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg.

Dosage for benign prostatic hyperplasia (BPH)

For symptoms of benign prostatic hyperplasia, the recommended dosage of Cialis is 5 mg once a day. You should take the drug at about the same time each day.

In some cases, your doctor may have you take 5 mg of Cialis a day along with finasteride (Proscar) to treat BPH. (See the “Cialis use with other drugs” section below to learn more.) If you take both Cialis and finasteride, you’ll usually take these two drugs for up to 26 weeks.

Dosage for erectile dysfunction (ED)

Here’s some information on the Cialis dosages for erectile dysfunction.

Cialis taken as needed

If your doctor recommends that you take Cialis only as needed for ED, the usual dosage is 10 mg before sexual activity. They may reduce this to 5 mg if the medication is working too well. But if this dose doesn’t work for you, your doctor may have you take two 5 mg tablets of Cialis at once. This will increase the dose back to 10 mg.

If the 10-mg dose of Cialis isn’t working well enough, your doctor may increase it to 20 mg. The maximum dose of Cialis that can be taken in a day is 20 mg.

You shouldn’t take Cialis more than once a day. In clinical trials, Cialis helped people with ED symptoms for up to 36 hours after their dose. So if you’re taking the medication only as needed, you shouldn’t have to take it every day.

Note: It’s very important that you take only the amount of Cialis that your doctor instructs you to take. And be sure to speak with them if you feel you need more of the drug, rather than increasing your dosage yourself.

Cialis taken once a day

Cialis can also be taken once a day to treat ED. In this case, the dosage usually starts at 2.5 mg a day. If this daily dosage doesn’t work well enough to treat your ED, your doctor may increase it to 5 mg a day.

And if your doctor recommends using Cialis every day, you should take the drug at about the same time each day. You don’t need to take Cialis before sexual activity unless your doctor says to use the drug only as needed. (See the “Cialis taken as needed” section right above to learn more.)

Note: It’s very important that you take only the amount of Cialis that your doctor instructs you to take. And be sure to speak with them if you feel you need more of the drug, rather than increasing your dosage yourself.

Dosage for ED and BPH

To treat both ED and symptoms of BPH together, the typical dose of Cialis is 5 mg, once a day. You should try to take your dose at about the same time each day.

Higher dosages of Cialis

The approved dosages of Cialis for ED, BPH symptoms, or both, are between 2.5 mg and 20 mg a day or as needed. Dosages higher than 20 mg a day haven’t been studied, and it’s not known what side effects may occur with them.

For example, if you take your “as-needed” dose of 20 mg twice a day, you’ll end up taking 40 mg. This dose is too high and may cause serious side effects, such as decreased blood pressure.

Note: It’s very important that you take only the amount of Cialis that your doctor instructs you to take. And be sure to speak with them if you feel you need more of the drug, rather than increasing your dosage yourself.

What if I miss a dose?

If you forget to take your once-a-day dose of Cialis, take it as soon as you remember. However, never take two doses in 1 day. If you missed your dose yesterday, just skip the missed dose and continue with your once-a-day dosing.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

If you’re using Cialis to treat BPH, this medication may be a long-term treatment. Cialis may also be used to treat ED long term.

But in some cases, your doctor may determine the cause of your ED, such as depression or an illness. In such instances, you may be able to stop taking Cialis after the cause of your ED has been treated.

Cialis can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Cialis. These lists don’t include all possible side effects.

For more information on the possible side effects of Cialis, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Cialis, you can do so through MedWatch.

Mild side effects

Mild side effects of Cialis can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Cialis. To learn about other mild side effects, talk with your doctor or pharmacist, or see Cialis’s Patient Package Insert.

Serious side effects

Serious side effects from Cialis aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

Other serious side effects, explained in more detail below in “Side effect details,” include:

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Cialis. Allergic reactions did occur in clinical trials of Cialis, but it wasn’t reported how many people had them. The allergic reactions included a serious rash and skin conditions such as Stevens-Johnson syndrome (a life threatening rash that causes painful blisters).

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Cialis. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Headache

Headache is a common side effect that may occur with Cialis. In clinical trials, depending on the condition being treated:

• between 3% and 15% of people who took Cialis had headaches
• between 2.3% and 5% of people who took a placebo (treatment with no active drug) had headaches

If you have headaches that are bothersome to you while using Cialis, talk with your doctor. They may be able to recommend ways to help ease this side effect.

Changes in blood pressure

Changes in blood pressure are a possible side effect of taking Cialis. Low blood pressure occurs most often while taking this medication. But high blood pressure can occur as well.

Clinical trials looked at blood pressure in people who took 20 mg of Cialis or a placebo. Blood pressure decreased by an average of 1.6/0.8 mm Hg more in the Cialis group than in the placebo group.

A decrease in blood pressure may be more likely if you’re taking Cialis along with other medications that can also lower blood pressure.

Symptoms of low blood pressure can include:

If you have these symptoms while taking Cialis, tell your doctor right away. They’ll help determine what’s causing the low blood pressure and the best way to treat it.

Although rare, Cialis may also increase your blood pressure. This was a side effect that was reported only in people who took Cialis once a day for erectile dysfunction (ED). In this trial, depending on the condition being treated:

If you have any symptoms of high blood pressure, such as headaches or chest pain, tell your doctor right away. They’ll help determine what’s causing the increase in blood pressure and the best way to treat it.

Back pain

Back pain is a common side effect with Cialis. In clinical trials, depending on the condition being treated, back pain was reported in:

Back pain usually occurs between 12 and 24 hours after taking Cialis. Usually, back pain goes away within 2 days of taking your dose.

While taking Cialis, if you have back pain that’s bothersome to you or doesn’t go away, talk with your doctor. They may be able to recommend ways to help ease this side effect. Your doctor may also do more testing to see what’s causing your back pain.

Heartburn

Heartburn is a common side effect of Cialis. In clinical trials, depending on the condition being treated, heartburn occurred in:

If you have heartburn that’s bothersome to you while taking Cialis, talk with your doctor. They may be able to recommend ways to treat this side effect.

Prolonged erection

It’s possible to get a prolonged erection that lasts more than 4 hours while taking Cialis. It wasn’t reported how many people had a prolonged erection in clinical trials.

This side effect can lead to priapism, which is a painful erection lasting longer than 4 hours. It’s considered an emergency because it can cause permanent damage to your penis, such as being unable to have erections at all.

If you have an erection that lasts longer than 4 hours while using Cialis, see a doctor or go to the hospital right away. The prolonged erection should be treated as soon as possible so that it doesn’t cause lasting damage.

Loss of vision

Very rarely, Cialis may cause a loss of vision in either one eye or both eyes. It’s not known how many people had a loss of vision in clinical trials. Also, it’s not known if Cialis was the cause of vision loss or if other factors play a role.

While taking Cialis, if you have any changes in vision, such as decreased vision or loss of vision, tell your doctor right away. They’ll help determine what’s causing the vision change and how to best treat it.

How to avoid Cialis side effects

The best way to take Cialis is to use it exactly as your doctor directs, either once a day at the same time each day or only as needed. You shouldn’t take any other medications to treat erectile dysfunction (ED) while you’re using Cialis, unless your doctor says that it’s OK. And you should never take Cialis more than once a day.

It’s also important to avoid drinking too much alcohol while you’re using Cialis. (See the “Cialis and alcohol” section below to learn more.)

In addition, be sure to talk with your doctor or pharmacist about any other medications that you’re taking. They’ll be able to determine if the drugs may interact with Cialis and if that may lead to an increased risk of side effects. If you have any questions about the best way to avoid specific side effects from Cialis, talk with your doctor.

You may wonder how Cialis compares with other medications that are prescribed for similar uses. Here we look at how Cialis and Viagra are alike and different.

Ingredients

The active drug ingredient in Cialis is tadalafil. The active drug ingredient in Viagra is sildenafil. Both Cialis and Viagra belong to a group of medications called phosphodiesterase 5 (PDE5) inhibitors.

Uses

The Food and Drug Administration (FDA) has approved Cialis and Viagra to treat erectile dysfunction (ED) in men. ED is a condition in which you can’t get or keep an erection.

Cialis is also FDA-approved to treat the following in men:

Drug forms and administration

Both Cialis and Viagra come as tablets that you swallow. Cialis may be taken once a day or just when needed for sexual activity. Usually, Viagra is taken only as needed for sexual activity.

Side effects and risks

Cialis and Viagra both contain medications to treat ED. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Cialis, with Viagra, or with both drugs (when taken individually).

• Can occur with Cialis:
  • pain in your arms or legs
  • abnormal vision
  • nausea
  • dizziness
  • rash
  • headache
  • flushing (warmth and redness in your skin)
  • heartburn
  • stuffy nose
  • back pain
  • muscle pain

  Serious side effects

  This list contains examples of serious side effects that can occur with Cialis and Viagra when taken individually.

  • prolonged erection (an erection that lasts more than 4 hours)
  • loss of vision
  • changes in hearing, such as trouble hearing or ringing in your ears
  • allergic reaction
  • changes in blood pressure

  Effectiveness

  Cialis and Viagra have different FDA-approved uses, but they’re both used to treat ED.

  The use of Cialis and Viagra in treating ED has been directly compared in clinical studies.

  One study’s results

  One study compared men who took Cialis either once a day or as needed with men who took Viagra as needed.

  • The study showed that men in the Cialis group had more improvement in their confidence than those in the Viagra group.
  • The Cialis group was also less concerned about how long their erection lasted than the Viagra group. This is because Cialis works longer than Viagra.

  Results from a second study

  In another ED study , men took either Cialis as needed or Viagra as needed for 4 weeks. They then switched to the other medication for an additional 4 weeks. Finally, the men decided which drug they preferred.

  Researchers found that 69.1% of men preferred Cialis and 30.9% of men preferred Viagra. Most often, men reported that they preferred Cialis because the medication lasts longer in the body.

  The study also looked at how well the drugs worked to treat ED. This was determined by a portion of a survey the men took called the International Index of Erectile Function (IIEF). A higher score on the IIEF meant that erectile function was better, so ED symptoms improved. Scores for self-esteem and relationship quality were about equal in the two groups.

  Costs

  Cialis and Viagra are both brand-name drugs. Currently, there are generic forms of both drugs. The generic form of Cialis is called tadalafil. The generic form of Viagra is called sildenafil. Brand-name medications usually cost more than generics.

  The costs of Cialis and Viagra will vary depending on your treatment plan. The generic versions of both Cialis and Viagra cost significantly less than the brand-name versions. The actual price you’ll pay for any of these drugs depends on your insurance plan, your location, and the pharmacy you use.

  Like Viagra (above), the drug Levitra has uses similar to those of Cialis. Here’s a comparison of how Cialis and Levitra are alike and different.

  Ingredients

  The active drug ingredient in Cialis is tadalafil. The active drug ingredient in Levitra is vardenafil. Both Cialis and Levitra belong to a group of medications called phosphodiesterase 5 (PDE5) inhibitors.

  Uses

  The Food and Drug Administration (FDA) has approved Cialis and Levitra to treat erectile dysfunction (ED) in men. ED is a condition in which you can’t get or keep an erection.

  Cialis is also FDA-approved to treat the following in men:

  Drug forms and administration

  Both Cialis and Levitra come as tablets that you swallow. Cialis can be taken once a day or as needed for sexual activity. Levitra is taken only as needed for sexual activity.

  Side effects and risks

  Cialis and Levitra both contain medications used to treat ED. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

  Mild side effects

  These lists contain up to 10 of the most common mild side effects that can occur with Cialis, with Levitra, or with each drug (when taken individually).

  • Can occur with Cialis:
    • pain in your arms or legs
    • sinus infection
    • flu symptoms, such as fever and cold sweats
    • dizziness
    • nausea
    • kidney problems, such as an increased level of creatine kinase (a measure of kidney function) in your blood
    • headache
    • flushing (warmth and redness in your skin)
    • stuffy nose
    • heartburn
    • back pain
    • muscle pain

    Serious side effects

    These lists contain examples of serious side effects that can occur with Cialis, with Levitra, or with both drugs (when taken individually).

    • an occur with Cialis:
      • no unique serious side effects
      • changes in heart rhythm called QT prolongation (long QT syndrome)
      • prolonged erection (an erection that lasts more than 4 hours)
      • allergic reaction
      • loss of vision
      • changes in hearing, such as trouble hearing or ringing in your ears
      • changes in blood pressure

      Effectiveness

      Cialis and Levitra have different FDA-approved uses, but they’re both used to treat ED.

      The use of Cialis and Levitra in treating ED has been directly compared in a clinical study, but the results weren’t released.

      Studies have found both Cialis and Levitra to be effective for treating ED.

      Costs

      Cialis and Levitra are both brand-name drugs. Currently, there are generic forms of both drugs. The generic form of Cialis is called tadalafil. The generic form of Levitra is called vardenafil. Brand-name medications usually cost more than generics.

      The costs of Cialis and Levitra will vary depending on your treatment plan. The generic versions of both Cialis and Levitra cost significantly less than the brand-name versions. The actual price you’ll pay for any of these drugs depends on your insurance plan, your location, and the pharmacy you use.

      Here’s a look at how the drugs Cialis and Adcirca compare.

      Uses

      Both Cialis and Adcirca have the same active drug ingredient, tadalafil. However, the Food and Drug Administration (FDA) has approved the drugs to treat different conditions.

      Cialis is FDA-approved to treat the following in men:

      • erectile dysfunction (ED), a condition in which you can’t get or keep an erection
      • symptoms of benign prostatic hyperplasia (BPH), a prostate condition that may cause problems with urination
      • ED and symptoms of BPH together

      Adcirca is approved to treat a type of high blood pressure in your lungs called pulmonary arterial hypertension (PAH). The drug is for use in men and women. PAH is a specific kind of pulmonary hypertension that occurs in the arteries of your lungs.

      Although these medications are very similar, they can’t be swapped. This means that if you’re taking Cialis for ED or symptoms of BPH, you shouldn’t take Adcirca instead. And if you’re taking Adcirca for PAH, you shouldn’t take Cialis instead.

      Drug forms and administration

      Although the active drug ingredient is the same in both Cialis and Adcirca, the two drugs have different dosages. If you’re taking Cialis, your dosage may be 2.5 mg to 20 mg as needed before sexual activity or once a day. But if you’re taking Adcirca, your dosage is usually 40 mg a day.

      You should take Cialis according to your doctor’s or healthcare provider’s instructions.

      Cialis comes as a tablet that you swallow.

      When to take

      Your doctor may want you to take Cialis once a day or just as needed for sexual activity. If you have questions about how often you can take Cialis if you’re using it as needed, talk with your doctor. Keep in mind that you should never take Cialis more than once a day.

      The best time to take Cialis depends on whether you’re taking it once a day or only as needed. If you’re using the medication once a day, be sure to take it at about the same time each day.

      If you’re taking Cialis only as needed, you may wonder how long before having sex you should take it. The best time to take an “as-needed” dose is about 2 hours before sex. This is because on average, it takes the drug 2 hours to be at the highest level in your body. So at about 2 hours, you’ll have the best effects from the medication. However, some people may have better erectile function 30 minutes after they take the drug.

      To help make sure that you don’t miss a once-a-day dose, try setting a reminder on your phone. A medication timer may be useful, too.

      Taking Cialis with food

      You can take Cialis with or without food.

      Can Cialis be crushed, split, or chewed?

      You shouldn’t crush, split, or chew Cialis. Swallow the tablet whole. It’s not known if the medication will be as safe and effective if you crush, split, or chew it.

      Here are answers to some frequently asked questions about Cialis.

      Can women take Cialis?

      No. Cialis isn’t approved for use in women. However, there are other options to treat women with a low sex drive.

      Bremelanotide (Vyleesi) is an injectable medication that works on an area of your brain to improve sexual desire. This drug is also known as PT-141. Another medication used to treat low sex drive in women is the pill flibanserin (Addyi).

      If you have questions about treating low sex drive in women, talk with your doctor.

      Does Cialis work and is it safe?

      Yes, the Food and Drug Administration (FDA) has approved Cialis. And before the FDA approves a medication, it must test the drug for safety and effectiveness. Clinical trials show that Cialis is a safe and effective drug to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), or both.

      However, for some people, Cialis may not be a safe option. This can include people with heart conditions such as an irregular heart rhythm and people who take other medications such as nitrates. (See the “Cialis precautions” section below to learn more.)

      Before you start using Cialis, be sure to tell your doctor about any medical conditions you have and any medications you’re taking. They’ll be able to decide if Cialis is a safe choice for you. And talk with your doctor if you have any concerns.

      Will Cialis help me keep an erection after ejaculating?

      No. After ejaculation, you’ll likely lose your erection even if you’re taking Cialis.

      After ejaculation occurs, your sexual excitement usually decreases. This means that you’ll likely lose your erection after ejaculation. And whether or not you’re using Cialis, you still need sexual stimulation to have an erection.

      However, Cialis can still work up to 36 hours after you take your dose. So the drug may help you get another erection.

      How long does Cialis stay in your system?

      Cialis can stay in your system for more than 2 days after your dose. If you’re using the medication as needed, the drug may still increase your ability to get and maintain an erection 2 days after your last dose.

      Can Cialis be used to treat ED after prostate surgery?

      Yes, Cialis can be used to treat ED after prostate surgery.

      A clinical trial was done in people with ED who had surgery to have their prostate removed. The people used either Cialis or a placebo (treatment with no active drug) as needed. After 4 weeks, the people took a portion of a survey called the International Index of Erectile Function (IIEF). A higher score on the IIEF meant that erectile function was better, so ED symptoms improved.

      • people who took Cialis after prostate surgery had an increase in their scores of about 5.3 points
      • people who took a placebo after prostate surgery had an increase of about 1.1 points

      If you have questions about using Cialis to treat ED after prostate surgery, talk with your doctor.

      Does Cialis increase the size of a man’s penis?

      No. Cialis doesn’t increase the size of a man’s penis. However, the medication does increase blood flow to the area. So if the penis wasn’t able to become fully erect before taking Cialis, it may appear larger after taking Cialis.

      Although Cialis doesn’t change the size of the penis, the drug can increase the ability to have an erection.

      Cialis is approved to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both of these conditions.

      Erectile dysfunction explained

      ED is a condition in which a man may be unable to get or maintain an erection. An erection occurs when blood flows into the penis and remains there for a period of time. This happens because the blood vessels and muscles in the penis relax and open up, allowing more blood to flow into the area.

      Cyclic guanosine monophosphate (GMP) is a chemical in your body that relaxes the muscles in the penis and increases blood flow into the penis. With ED, this activity isn’t working properly, so you can’t have or maintain an erection.

      What Cialis does for ED

      Cialis belongs to a group of medications called phosphodiesterase 5 (PDE5) inhibitors. It works to treat ED by blocking PDE5. When PDE5 is blocked, your body makes more cyclic GMP. And when you have more cyclic GMP, the blood vessels and muscles in your penis relax. This allows more blood to flow in and produce an erection.

      Benign prostatic hyperplasia explained

      BPH is a condition in which the prostate gland gets larger but isn’t cancerous. BPH may cause problems with urination such as the need to urinate frequently or having to urinate more often at night.

      What Cialis does for BPH symptoms

      Cialis is approved to treat the symptoms of BPH, but it’s not known exactly how the drug does this. It’s believed that Cialis works by relaxing muscles in your bladder, which allows you to urinate more easily.

      How long does it take for Cialis to work?

      Cialis works fairly quickly to treat your ED, BPH symptoms, or both conditions. Studies show that the medication may work as quickly as 30 minutes after you take your dose. However, in some people, the medication may take up to 6 hours until you notice it working.

      On average, it takes about 2 hours for Cialis to peak. This is how long it takes for you to have the highest level of medication in your body. This is when the drug should work the best to treat your ED, symptoms of BPH, or both conditions.

      Both alcohol and Cialis can decrease your blood pressure. So if you drink alcohol while taking this medication, it’s recommended that you don’t drink too much. This may help prevent your blood pressure from becoming too low.

      Having five or more drinks (five shots or glasses of wine or beer) along with Cialis can increase the risk of side effects. In addition to decreased blood pressure, these side effects can include:

      If you drink alcohol, talk with your doctor about what amount is safe to drink while you’re taking Cialis.

      Other drugs are available that can treat your erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both. Some medications may be a better fit for you than others. If you’re interested in finding an alternative to Cialis, talk with your doctor. They can tell you about other drugs that may work well for you.

      Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

      Alternatives for benign prostatic hyperplasia (BPH)

      Examples of other drugs that may be used to treat symptoms of BPH include:

      • alfuzosin (Uroxatral)
      • doxazosin (Cardura)
      • silodosin (Rapaflo)
      • tamsulosin (Flomax)
      • dutasteride (Avodart)
      • finasteride (Proscar)

      Alternatives for erectile dysfunction (ED)

      Examples of other drugs that may be used to treat ED include:

      Alternatives for ED and BPH

      Cialis is the only medication that the Food and Drug Administration (FDA) has approved to treat both ED and symptoms of BPH together. However, other combinations of drugs may be used for this purpose. Also, other single medications may be used off-label to treat both ED and symptoms of BPH together.

      Examples of other drugs that may be used to treat ED and symptoms of BPH together include:

      Using more than the recommended dosage of Cialis can lead to serious side effects.

      Don’t use more Cialis than your doctor recommends.

      Overdose symptoms

      Doses of up to 500 mg of Cialis have been tested. Doses of up to 100 mg have also been given to people once a day. Overdose symptoms were similar to the normal side effects people have had after taking Cialis. (For more about side effects, see the “Cialis side effects” section above.)

      What to do in case of overdose

      If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

      If you’re taking Cialis, you usually won’t have to use other medications with it.

      But if you have a prostate condition called benign prostatic hyperplasia (BPH), your doctor may first prescribe a drug called finasteride (Proscar).

      Finasteride is a first-line treatment (the first treatment used) when medications are recommended for BPH. This is because the drug shrinks the prostate by blocking the growth of prostate cells. Cialis treats the symptoms of BPH by reducing the prostate gland muscle tone, but it doesn’t block the growth of the cells.

      Finasteride can help also ease symptoms of BPH, such as having to urinate suddenly and more often. However, this medication can cause negative sexual side effects such as decreased libido (sex drive) and erectile dysfunction. To help ease these side effects, your doctor may have you also take Cialis.

      If you have questions about using Cialis and finasteride, talk with your doctor.

      What can I take to enhance Cialis?

      You shouldn’t take anything in addition to Cialis to enhance the drug, unless your doctor tells you to.

      When you get Cialis from the pharmacy, the pharmacist will add an expiration date to the label on the package or bottle. This date is typically 1 year from the date they dispensed the medication.

      The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

      Storage

      How long a medication remains good can depend on many factors, including how and where you store the medication.

      You should store Cialis tablets at 77°F (25°C). But you can keep them between 59°F and 86°F (15°C and 30°C) for short periods of time, if needed. Store Cialis in a tightly sealed container away from light. And avoid keeping this medication in areas where it could get damp or wet, such as bathrooms.

      Disposal

      If you no longer need to take Cialis and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

      This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

      Cialis can interact with several other medications. It can also interact with certain foods.

      Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

      Cialis and other medications

      Below is a list of medications that can interact with Cialis. This list doesn’t contain all drugs that may interact with Cialis.

      Before taking Cialis, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

      If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

      Cialis and nitrates

      You shouldn’t take Cialis if you’re taking a medication called a nitrate. This type of drug may be used for chest pain. Taking nitrates along with Cialis can cause a serious decrease in your blood pressure.

      However, in some cases, you doctor may give you a nitrate: for example, if you have chest pain and your life is at risk, and it’s been at least 48 hours since your last dose of Cialis. After you receive the nitrate, your doctor will likely monitor you to make sure your blood pressure doesn’t drop to an unsafe level.

      Cialis and alpha-blockers

      Both Cialis and medications called alpha-blockers can cause a decrease in blood pressure. So taking these medications together can cause blood pressure to drop further.

      If you have benign prostatic hyperplasia (BPH) and are taking a medication called an alpha-blocker, you shouldn’t use Cialis.

      And if you have erectile dysfunction (ED) and are taking an alpha-blocker, your doctor will likely lower your dose of Cialis.

      Examples of alpha-blocker drugs include:

      Before taking Cialis, tell your doctor about any medications that you use, including alpha-blockers.

      Cialis and medications that lower blood pressure

      Cialis may reduce your blood pressure. So if you’re taking other medications to reduce your blood pressure, using Cialis along with them may cause a larger drop in blood pressure.

      Examples of blood pressure medications include:

      Before you start Cialis treatment, tell your doctor if you’re taking any blood pressure drugs. They may give you a lower dose of Cialis or monitor you more often.

      Cialis and medications to treat heartburn

      If you’re taking Cialis and use antacids to treat heartburn, the antacids may decrease the level of Cialis that your body absorbs. This means that you may not get the full dose of Cialis, so it may not work as well to treat your ED or symptoms of BPH.

      Before you start using Cialis, tell your doctor if you’re taking antacids. Talk with them about how far apart to take the doses of each drug if you need to use both medications.

      Cialis and CYP3A4 inhibitors

      Cialis is broken down in your body by an enzyme in your liver called CYP3A4. (An enzyme is a protein that aids chemical changes in your body.) Certain drugs can inhibit (block) this enzyme from working. So if the enzyme is unable to break down Cialis, the level of Cialis in your body may get too high. This can be dangerous and may increase your risk of side effects from Cialis. (For more about side effects, see the “Cialis side effects” section above.)

      Examples of medications that can block CYP3A4 from working include:

      Before starting Cialis treatment, talk with your doctor about any medications that you’re taking. They’ll be able to determine if the drugs are CYP3A4 inhibitors and if they can interact with Cialis. In some cases, your doctor may recommend a lower dose of Cialis or a different medication to treat your ED, symptoms of BPH, or both.

      Cialis and CYP3A4 inducers

      Cialis is broken down in your liver by an enzyme called CYP3A4. Certain drugs may induce (increase the activity of) CYP3A4, making it work better or faster than usual. This means that your body may break down Cialis more quickly than it should, so the drug may not affect you.

      Examples of drugs that induce CYP3A4 include:

      Before you start to use Cialis, talk with your doctor about any medications that you’re taking. They’ll be able to determine if the drugs are CYP3A4 inducers and if they can interact with Cialis. In some cases, your doctor may recommend a different medication to treat your ED, symptoms of BPH, or both.

      Cialis and guanylate cyclase stimulators

      You shouldn’t take Cialis if you’re using a type of drug called a guanylate cyclase stimulator. This kind of medication is used to treat people with pulmonary hypertension (a type of high blood pressure in your lungs). Using a guanylate cyclase stimulator along with Cialis may cause your blood pressure to become dangerously low.

      An example of a guanylate cyclase stimulator is riociguat (Adempas). This medication can be used to treat pulmonary hypertension (PH) that happens in your arteries of your lungs (pulmonary arterial hypertension) or PH that happens due to a blood clot in your lungs.

      Before taking Cialis, talk with your doctor about any medications you’re using for pulmonary hypertension. If you’re taking riociguat, they’ll likely recommend a different medication to treat your ED, BPH symptoms, or both.

      Cialis and herbs and supplements

      There aren’t any herbs or supplements that have been specifically reported to interact with Cialis. However, you should still check with your doctor or pharmacist before using any of these products while taking Cialis.

      Cialis and foods

      Here’s some information about how Cialis may interact with alcohol and grapefruit.

      Alcohol

      Both alcohol and Cialis can decrease your blood pressure. So if you drink alcohol while taking this medication, it’s recommended that you don’t drink too much. This may help prevent your blood pressure from becoming too low. For more information, see the “Cialis and alcohol” section above.

      Grapefruit

      While you take Cialis, it’s best to avoid eating grapefruit and drinking grapefruit juice.

      Cialis is broken down in your body by an enzyme in your liver called CYP3A4. Grapefruit blocks that enzyme from working. So if the enzyme is unable to break down Cialis, the level of Cialis in your body may get too high. This can be dangerous and may increase your risk of side effects from Cialis. (For more about side effects, see the “Cialis side effects” section above.)

      As with all medications, the cost of Cialis can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

      Before approving coverage for Cialis, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Cialis.

      If you’re not sure if you’ll need to get prior authorization for Cialis, contact your insurance company.

      Financial and insurance assistance

      If you need financial support to pay for Cialis, or if you need help understanding your insurance coverage, reach out to your insurance company. They can aid you and tell you if there are any financial assistance options available.

      Generic version

      Cialis is available in a generic form called tadalafil. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.

      If your doctor has prescribed Cialis and you’re interested in using tadalafil instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

      Cialis isn’t approved for use in women. And there’s no information on Cialis use in pregnant women, so it’s not known if this medication is safe or effective for them.

      Animal studies showed no problems with development of the fetus when the mother was given Cialis while pregnant. But animal studies don’t always predict what will happen in humans.

      If you have questions about Cialis use during pregnancy, talk with your doctor.

      Cialis isn’t approved for use in women. And it’s not known if the drug is safe to take during pregnancy.

      If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Cialis.

      For more information about taking Cialis during pregnancy, see the “Cialis and pregnancy” section above.

      Cialis isn’t approved for use in women. And it’s not known if Cialis passes into breast milk or if it can be harmful to a breastfed child.

      In animal studies, Cialis was present in breast milk. But animal studies don’t always predict what will happen in humans.

      If you have questions about Cialis and breastfeeding, talk with your doctor.

      This drug comes with several precautions. Before taking Cialis, talk with your doctor about your health history. Cialis may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

      • Heart problems. Sexual activity has an impact on your heart function. So if you have a history of heart problems, talk with your doctor before taking Cialis. These heart problems can include a heart attack or an irregular heart rhythm. Your doctor will be able to tell you if your heart is healthy enough for you to have sex. And if you have symptoms such as chest pain or an irregular heartbeat while taking Cialis, you should stop any sexual activity and see a doctor as soon as possible.
      • Pulmonary hypertension. If you have pulmonary hypertension (a type of high blood pressure in your lungs), talk with your doctor before taking Cialis. In some cases, you may be taking a medication called riociguat (Adempas) to treat your pulmonary hypertension. And using this medication along with Cialis may cause your blood pressure to become dangerously low. You shouldn’t take Cialis if you’re taking riociguat for pulmonary hypertension.
      • Blood pressure problems. Cialis can cause both high blood pressure and low blood pressure. So if you already have either of these conditions, Cialis may make it worse. And you may be at a higher risk for symptoms from changes in blood pressure. (To learn more, see “Changes in blood pressure” in the “Side effect details” section above.) If you have a history of blood pressure problems, tell your doctor before you take Cialis. During your treatment, they may have you monitor your blood pressure more often to make sure it doesn’t become too high or too low.
      • Stroke. Cialis may increase your risk for stroke, especially if you have a history of stroke. In studies conducted after Cialis was approved, some people with a history of heart problems had strokes. If you have a history of stroke, be sure to talk with your doctor before taking Cialis. They’ll be able to determine if the medication is safe for you.
      • Liver problems. If you have a history of liver problems, such as hepatitis or liver failure, your body may not break down Cialis quickly enough. This means that the drug can build up in your system, which may increase your risk of side effects from the medication. (To learn more, see the “Cialis side effects” section above.) If you have liver problems, be sure to talk with your doctor before taking Cialis. They may have you start with a low dose.
      • Kidney problems. If you have kidney problems, such as chronic kidney disease, your body may not be able to get rid of Cialis as quickly as it should. This means that the medication may build up in your body, which can cause serious side effects. (To learn more, see the “Cialis side effects” section above.) If you have kidney problems, tell your doctor before you take Cialis. They may have you start with a low dose of the medication.
      • Severe vision loss. If you have any history of vision loss, talk with your doctor before taking Cialis. This vision loss may include having vision conditions such as non-arteritic anterior ischemic optic neuropathy (NAION). Using Cialis when you have vision loss may increase your risk for developing vision side effects. (See “Loss of vision” in the “Side effect details” section to learn more.) Your doctor may recommend a different medication than Cialis.
      • Retinitis pigmentosa. If you have retinitis pigmentosa (a genetic eye condition that may cause vision loss), you shouldn’t use Cialis. Taking Cialis when you have vision loss may increase your risk for developing vision side effects. (See “Loss of vision” in the “Side effect details” section to learn more.) Your doctor may recommend a different medication than Cialis.
      • Stomach ulcers. It’s possible that Cialis may increase your risk for bleeding. So if you have a history of stomach ulcers, taking Cialis may increase your risk of developing bleeding ulcers. (Stomach ulcers are sores in the lining of your stomach or intestine, and they may bleed.) Talk with your doctor before taking Cialis if you have a history of stomach ulcers. They may recommend a different treatment.
      • Bleeding problems. Cialis may increase your risk for bleeding. If you have a history of bleeding problems, such as hemophilia, taking Cialis may further increase your risk for bleeding. Talk with your doctor before taking Cialis if you have a history of bleeding problems. They may recommend a different treatment.
      • Deformed penis or Peyronie’s disease. If you have a deformed penis or a history of Peyronie’s disease (a curved penis), tell your doctor before taking Cialis. You may be at an increased risk for developing a long-lasting erection if you take the drug. Blood may become trapped in the penis and lead to an erection lasting longer than 4 hours, which can be dangerous and cause lasting damage. Your doctor will probably have you take a low dose of Cialis or use the medication with caution.
      • History of erections lasting longer than 4 hours. If you have a history of prolonged erections or priapism, you may be at an increased risk for developing them while taking Cialis. A prolonged erection is one that lasts more than 4 hours. And priapism is a painful erection that lasts more than 6 hours. Both conditions are considered emergencies and need to be treated right away to prevent long-term damage. So if you’ve had prolonged erections or priapism in the past, tell your doctor before you take Cialis. They may have you carefully monitor your condition after using Cialis.
      • Blood cell problems. Blood cell problems can include sickle cell anemia and blood cancers such as multiple myeloma or leukemia. If you have a blood cell problem, tell your doctor before using Cialis. You may be at an increased risk for developing a long-lasting erection when taking the drug. Erections lasting longer than 4 hours can be dangerous and may cause permanent damage. Your doctor may recommend a low dose of Cialis if you have blood cell problems.
      • Allergic reaction. If you’ve had an allergic reaction to Cialis or any of its ingredients, you shouldn’t take Cialis. Ask your doctor what other medications are better options for you.
      • Pregnancy. Cialis isn’t approved for use in women. And it’s not known if the medication is safe to take during pregnancy. For more information, please see the “Cialis and pregnancy” section above.
      • Breastfeeding. Cialis isn’t approved for use in women. And it’s not known if this medication is safe to take while breastfeeding. For more information, please see the “Cialis and breastfeeding” section above.

      Note: For more information about the potential negative effects of Cialis, see the “Cialis side effects” section above.

      The following information is provided for clinicians and other healthcare professionals.

      Indications

      Cialis is indicated for the treatment of erectile dysfunction (ED) and the signs and symptoms of benign prostatic hyperplasia (BPH). It is also approved to treat men with both ED and BPH.

      Administration

      Cialis is a tablet that is taken orally. It is taken either once daily or only as needed.

      Mechanism of action

      Cialis is a phosphodiesterase 5 (PDE5) inhibitor. For ED, it works by blocking PDE5, which then increases cyclic guanosine monophosphate (GMP). The increase in cyclic GMP causes relaxation of smooth muscles and arteries, leading to more blood flowing into the penis.

      It is not known exactly how Cialis works to treat symptoms of BPH. However, it is believed to work by relaxing smooth muscles around the prostate and bladder, leading to decreased urinary symptoms.

      Pharmacokinetics and metabolism

      After Cialis is dosed, the maximum concentration (Cmax) occurs between 30 minutes and 6 hours post-dose. The average Cmax occurs at 2 hours post-dose. Steady state is achieved after 5 days of once-daily dosing.

      Volume of distribution of Cialis is about 63 L. It is highly protein-bound at about 94%.

      Cialis is metabolized in the liver via CYP3A4 at first. It is then methylated and glucuronidated into its metabolized product, methylcatechol glucuronide.

      Cialis is then excreted, 61% being present in the feces and 36% in the urine.

      The half-life of Cialis is about 17.5 hours.

      Contraindications

      • patients taking nitrates
      • patients with a history of an allergic reaction to Cialis or tadalafil (Adcirca)
      • patients taking guanylate cyclase stimulators, such as riociguat (Adempas)

      Storage

      Cialis should be stored at 77°F (25°C), but brief deviations are permitted between 59°F and 86°F (15°C and 30°C).

      Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

      Cialis – Uses, Side Effects, and More

      Tadalafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, tadalafil works by increasing blood flow to the penis to help a man get and keep an erection.Tadalafil is also used to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate frequently or urgently (including during the middle of the night). Tadalafil is thought to work by relaxing the smooth muscle in the prostate and bladder.This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice “safe sex” such as using latex condoms. Consult your doctor or pharmacist for more details.

      How to use Cialis

      Read the Patient Information Leaflet provided by your pharmacist before you start taking tadalafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

      Take this medication by mouth, with or without food, as directed by your doctor. Do not take tadalafil more often than once daily.

      The manufacturer directs to swallow this medication whole. However, many similar drugs (immediate-release tablets) can be split/crushed. Follow your doctor’s directions on how to take this medication.

      The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

      To treat the symptoms of BPH, take this medication as directed by your doctor, usually once a day. If you are also taking finasteride with this medication to treat symptoms of BPH, talk with your doctor about how long you should continue taking this medication.

      To treat erectile dysfunction-ED, there are 2 ways that tadalafil may be prescribed. Your doctor will determine which is the best way for you to take tadalafil. Follow your doctor’s directions exactly since your dosage depends on how you are taking it. The first way is to take it as needed, usually at least 30 minutes before sexual activity. Tadalafil’s effect on sexual ability may last up to 36 hours.

      The second way to treat ED is to take tadalafil regularly, once a day every day. If you take it this way, you may attempt sexual activity at any time between your doses.

      If you are taking tadalafil to treat both ED and BPH, take it as directed by your doctor, usually once a day. You may attempt sexual activity at any time between your doses.

      If you are taking tadalafil once daily for BPH, or for ED, or for both, take it regularly to get the most benefit from it. To help you remember, take it at the same time each day.

      Tell your doctor if your condition does not improve or if it worsens.

      Side Effects

      Headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

      To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

      Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

      Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea.

      Rarely, sudden decreased vision, including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking tadalafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems (“crowded disk”), high blood pressure, if you are over 50, or if you smoke.

      Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking tadalafil and get medical help right away if these effects occur.

      In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

      A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

      This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

      In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

      In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

      Precautions

      Before taking tadalafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

      Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, dehydration, penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION), bleeding disorders, active stomach ulcers.

      This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

      Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

      This brand of the drug is not usually used in women. During pregnancy, tadalafil should be used only when clearly needed. Discuss the risks and benefits with your doctor.

      It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

      Interactions

      Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

      A product that may interact with this drug is: riociguat.

      Tadalafil can cause a serious drop in your blood pressure when used with nitrates, which can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use any of the following with tadalafil or within 48 hours of your last dose of tadalafil: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl or butyl nitrite.

      If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of tadalafil or adjust your alpha blocker medication to minimize your risk of low blood pressure.

      Other medications can affect the removal of tadalafil from your body, which may affect how tadalafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as fosamprenavir, ritonavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), rifampin, among others.

      Do not take this medication with any other product that contains tadalafil or other similar medications used to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, vardenafil).

      Tadalafil (Generic Cialis)

      Get Tadalafil mailed to you after an online visit with a member of our medical team. We can give you a prescription for 10 Generic Cialis pills at a time, with 11 refills. Make sure you know your blood pressure before you start a visit.

      52% of men experience some kind of erectile dysfunction throughout their life

      What is Tadalafil?

      Tadalafil is the active ingredient in a branded drug called Cialis. Tadalafil is approved by the FDA to treat erectile dysfunction. It’s available from Lemonaid in 5mg, 10mg and 20mg strength. We don’t prescribe the 2.5mg dose.

      Why is it called generic Cialis?

      Tadalafil is the active ingredient in the ED medicine that’s made by Lilly and branded as Cialis. Generic Cialis has the same active ingredient as the branded version and is approved by the FDA, but isn’t made by Lilly.

      Can I get generic Cialis mailed to me?

      Yes, after an online consultation with one of our doctors or nurse practitioners, you can get the pills mailed to you from the Lemonaid Pharmacy in discreet plain packaging with FREE fast delivery. Get started by completing an online visit.

      What’s the difference between the doses?

      We prescribe 3 different doses: 5mg, 10mg and 20mg. The starting dose we generally recommend is the 10mg pill.

      Most men start with and respond well to the 10 mg tadalafil dose. A higher dose of tadalafil is needed if your body does not respond to the recommended dose. The trade-off is that the higher the strength, the greater the chance of side-effects and adverse events. Our Lemonaid doctors or nurse practitioners can advise the right dose for you.

      If the dose we prescribe doesn’t work after you’ve tried it a few times, we can increase the dose to see if a higher strength of generic Cialis pill works better. Likewise, if you experience side effects, we may recommend that you try a lower dose of Tadalafil. We will ask about your experience with generic Cialis as part of your visit.

      Do I need a prescription for Tadalafil?

      Yes. Tadalafil requires a prescription. Lemonaid doctors and nurse practitioners are licensed to prescribe in all the states where we operate.

      Our erectile dysfunction Rx options

      We offer prescription medications clinically proven to help improve erections.

      Viagra

      Most common PDE5 drug that lasts in your system for 4 – 6 hours.

      Cialis

      Most common fast-acting PDE5 drug that lasts in your system for up to 18 hours.

      Sildenafil

      PDE5 drug that lasts in your system for 4 – 6 hours.

      Tadalafil

      Fast-acting PDE5 drug that lasts in your system for up to 18 hours.

      $2/pill with our mail order partner. Prices at Walgreens/CVS can be $18/pill.

      How it works

      Answer confidential assessment

      A doctor or nurse practitioner will message you within 1 day

      FREE fast delivery to your door

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      Lemonaid Health is a national online doctor’s office. Our services are provided by one of our four medical groups. All four medical groups do business as ‘Lemonaid Health’. In all states other than Kansas, New Jersey and Texas, Lemonaid services are provided by LMND Medical Group, Inc., A Professional Corporation, doing business as Lemonaid Health. In Kansas, Lemonaid services are provided by LMND Medical Group, A Professional Association, with registered office 112 SW 7TH Street, Suite 3C, Topeka, KS 66603. In New Jersey, Lemonaid services are provided by LMND Medical Group Professional Corporation, with registered office 820 Bear Tavern Road, West Trenton, NJ 08628. In Texas, Lemonaid services are provided by LMND Medical Group, A Professional Association, with registered office 1999 Bryan Street, Suite 900, Dallas, TX 75201. Our team is based at 870 Market Street, Suite 415, San Francisco CA 94102, USA. You can call us on 888-536-2267.

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      4 places to safely buy Cialis online 2023

      Cialis is a brand-name medication with approval to treat erectile dysfunction and other sexual health conditions in males. It is available to buy from some online telehealth companies but requires a prescription.

      This article explores Cialis in more detail and lists some companies that offer this drug. It also looks at some safety considerations, frequently asked questions, and when to speak with a doctor for erectile dysfunction.

      A quick look at the best places to buy Cialis online:

      • Best affordable Cialis:Roman
      • Best for insurance coverage:Lemonaid
      • Best subscription with free consultations:Hims
      • Best for discreet packaging:K Health

      Cialis is a medication that doctors may prescribe to people who have difficulty maintaining an erection.

      Its main ingredient is tadalafil, which helps increase blood flow to the penis to cause an erection. Tadalafil is also useful for treating pulmonary hypertension and symptoms of an enlarged prostate.

      Tadalafil tablets are available with a prescription. Individuals can take them with or without food.

      Depending on how the body responds to the medication, doctors may adjust a person’s Cialis prescription dosage. If a person experiences side effects such as dizziness, headaches, and a rapid heartbeat, they should inform their doctor and stop taking Cialis immediately.

      Viagra is another brand of medication that can treat erectile dysfunction. It contains sildenafil, whereas Cialis contains tadalafil.

      FDA approval

      Both Cialis and Viagra belong to a group of medications that researchers call phosphodiesterase 5 (PDE5) inhibitors. These include sildenafil, tadalafil, vardenafil, and avanafil, which have the Food and Drug Administration (FDA)’s approval to treat erectile problems.

      Side effects

      Tadalafil, or Cialis, does not usually cause significant side effects. However, some people may develop mild side effects, including:

      Cialis may not suit those with chest pain and take nitrates, as this combination can lower blood pressure to a dangerous level.

      Individuals who take Viagra or sildenafil may experience:

      Available forms and administration

      Viagra and Cialis are both available as tablets.

      People may take tadalafil once daily or 30 minutes before engaging in sexual activity.

      People can take sildenafil up to 4 hours before sexual intercourse.

      Medical News Today chooses ED products that meet the following criteria:

      • Company reputation:MNT selects products from brands that have undergone internal vetting of medical and business standards. The brands we choose are reputable and reliable, with positive reviews and transparent business practices.
      • Product transparency:MNT selects products that state ingredients, side effects, and recommended dosage clearly.
      • Safety:MNT selects brands that require a doctor’s prescription before customers can order Cialis. This ensure that a person can safely take Cialis and that the provider is responsible.
      • Price:MNT selects products that suit a range of budgets, including choosing brands that offer both brand-name and generic Cialis.

      Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

      Medical News Today follows a strict product selection and vetting process. Learn more here.

      Best affordable Cialis: Roman

      Roman sells the following versions of Cialis:

      • Generic: This is available in tablets of 2.5, 5, 10, and 20 mg, starting from $11.
      • Daily Generic: This is available in doses of 2.5 and 5 mg at $8.
      • Branded Cialis: This is available in doses of 2.5, 5, 10, and 20 mg, starting from $17.
      • Daily branded Cialis: This version comes in doses of 2.5 and 5 mg, costing $13.

      Roman’s doctors do not currently treat BPH, so the medication is only available from this company for individuals with erectile dysfunction.

      The company requires people to have an online consultation with a doctor before issuing a prescription, which occurs within 24 hours of a person enquiring. The consultation costs $15 and is currently available to people in the United States.

      If the doctor thinks the medication is not suitable for the individual and they do not issue a prescription, a customer will receive a full refund. Please note that there is no insurance coverage for consultations.

      Roman also offers free 2-day shipping and follow-up visits.

      Also, the platform’s services come with pros and cons:

      Pros

      • refunds when prescriptions do not apply
      • free shipping
      • free follow-up visits
      • option to cancel a subscription at any time

      Cons

      Best for insurance coverage: Lemonaid

      • As needed: Pricing starts at $65 per tablet. This is available in doses of 5 milligrams (mg), 10 mg, and 20 mg.
      • Daily: A 5-mg tablet with brand pricing starting from $50 per tablet.
      • Generic tadalafil: A 20-mg tablet starting at $2 per tablet and higher doses starting at $25 per tablet.

      To obtain tadalafil from Lemonaid, a person fills in a private online assessment, giving details about their medical history and other medications. After this, a doctor or nurse makes contact within 1 day. Some states require a video chat, while others require a short phone call.

      These consultations usually cost around $25, covering the prescription, not the medication. The company also needs a blood pressure reading, and a person can obtain this by finding a machine near them.

      In addition, insurance does not cover the cost of medical consultation. However, it may cover the cost of the medication, so a person can contact their insurance provider for more information.

      Pros

      • possible insurance coverage for medications
      • the medical team gets in touch with users within 24 hours
      • discreet packaging and free shipping

      Cons

      Best subscription with free consultations: Hims

      Hims sells both the brand-name and generic form of Cialis, and it offers a 5-mg dose that people can take once daily, with or without food.

      Those who wish to use Hims’ services must complete a questionnaire about their medical history, lifestyle, and symptoms. The company can connect them with a qualified healthcare professional in the same state.

      • Daily generic: Available as a 2.5- or 5-mg daily pill.
      • Generic: Available in doses of 5 mg, 10 mg, or 20 mg for when a person needs it.
      • Branded Cialis: Available in doses of 2.5 mg, 5 mg, 10 mg, and 20 mg for when a person needs it.

      The cost of the medication is $570 per month for Branded Cialis and $240 per month for generic tadalafil

      Online consultations are free of charge.

      Insurance does not cover product fees, but the prices are 50–80% less than the retail cost.

      Hims offers advantages and disadvantages that a person may consider:

      Pros

      • free online consultations
      • response within 24 hours
      • different products available for men
      • works with fully-licensed doctors

      Cons

      Best for discreet packaging: K Health

      K Health offers medical care and prescription medications online like other telehealth providers. A person can use the website or app to book consultations with doctors and manage any resulting prescriptions.

      K Health offers generic Cialis in doses of 5 mg, 10 mg, or 20 mg, starting from $1.80 per 10-mg dose.

      According to the company’s website, a person must complete an online assessment before matching with a doctor.

      Patients do not need to use medical insurance. Instead, they can pay $35 per doctor’s appointment or $49 for unlimited consultations. However, this cost only covers the appointment and not the prescription.

      Pros

      Cons

      The table below compares the above brands for buying Cialis online:

      branded as needed: $65 per tablet

      branded as needed: from $17

      When considering which generic or branded Cialis, a person should first consult with a medical professional to determine the best version and dosage for them.

      In addition, an individual may wish to research the company to ensure it conducts itself ethically and provides quality products equivalent to other verified generic or branded medications.

      Cialis comes as a tablet that people can take either with or without food.

      Individuals with erectile dysfunction and are sexually active should take this medication at least 30 minutes before engaging in sexual activity. They can also take it once daily if they do not wish to keep track of the timing of sexual activity. People should not take more than one tablet within 24 hours.

      An on-demand dose is 10 or 20 mg, while a daily dose should be 2.5 or 5 mg.

      People should always follow the doctor’s instructions, as they may increase or decrease the dose depending on how the person’s body responds to treatment.

      In addition, those who have erectile dysfunction or BPH symptoms and choose to take Cialis once per day should take it around the same time daily. Daily dosing may suit people who have frequent sexual intercourse or prefer more spontaneity.

      People who experience regular symptoms of erectile dysfunction should contact a doctor to discuss treatment options.

      When taking Cialis, a person should consult a doctor or seek emergency medical treatment if they develop any of the following symptoms:

      • blurry vision
      • vision loss
      • a sudden decrease or loss of hearing
      • ringing in the ears
      • an erection that lasts for longer than 4 hours
      • dizziness
      • chest pain
      • hives
      • a rash
      • breathing difficulties
      • swallowing difficulties
      • blistering skin or peeling skin
      • swelling

      The following are some frequently asked questions about Cialis.

      How to get Cialis or tadalafil online?

      A person can purchase branded Cialis or generic tadalafil online from a reputable telehealth provider. This typically involves filling out an online assessment, after which a medical professional reaches out for a virtual consultation and provides the prescription. However, a person must purchase the medication from a reputable telehealth provider.

      Is it safe to buy Cialis online?

      The FDA warns that many pharmacies are operating online. A person should always check reviews and recognize the signs that help them determine whether an online pharmacy is reputable or not.

      According to the FDA, online pharmacies are likely safe if they:

      • require a doctor’s prescription
      • have headquarters in the U.S. and provide a physical address and telephone number within the country
      • have licensed pharmacists or physicians
      • have a license with the state board of pharmacy

      Can people buy Cialis over the counter?

      Cialis is only available with a prescription. Some online pharmacies can provide prescriptions if the customer does not already have one.

      Can people get Cialis without visiting a doctor?

      A person does not need to consult a doctor to get Cialis treatment, as they can use telemedicine services to receive prescriptions. However, they may have to book an online consultation with a licensed healthcare professional if they use these services.

      In addition, individuals should not give their prescribed medication to others.

      Those with erectile dysfunction or BPH symptoms should seek medical advice, as the medication can cause side effects and interact with other medications. Additionally, the drug may not be safe for everyone.

      Do you need a prescription for Cialis?

      Cialis is only available with a prescription. There is no need to visit an in-person doctor’s clinic for this, as a person can use a telehealth company’s service if they wish to talk with a doctor online.

      How do I make sure I get genuine Cialis?

      People who do not feel comfortable discussing their sexual health problems with a physician face to face, can check whether a telehealth company offers the services and treatment that they may need.

      Getting Cialis from an online provider can be safe. Make sure that the company meets the following criteria:

      Various online pharmacies offer Cialis. A person may need an online consultation with a licensed doctor who may prescribe if the drug suits the individual.

      An online pharmacy’s services may be safe if the company asks for a prescription and has a valid, U.S.-based address, phone number, and a suitable license with the state board of pharmacy.

      Last medically reviewed on October 25, 2022

      How we reviewed this article:

      Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

      • Considering an online pharmacy? (2020).
        https://www.fda.gov/drugs/besaferx-your-source-online-pharmacy-information/considering-online-pharmacy
      • Dhaliwal, A., et al. (2022). PDE5 inhibitors.
        https://www.ncbi.nlm.nih.gov/books/NBK549843/
      • Erectile dysfunction (ED). (n.d.).
        https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
      • How and when to take sildenafil. (2022).
        https://www.nhs.uk/medicines/sildenafil-viagra/how-and-when-to-take-sildenafil/
      • Smith, B. P., et al. (2022). Sildenafil.
        https://www.ncbi.nlm.nih.gov/books/NBK558978/
      • Symptoms & causes of erectile dysfunction. (2017).
        https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
      • Tadalafil. (2019).
        https://www.nhs.uk/medicines/tadalafil/
      • Tadalafil. (2022).
        https://medlineplus.gov/druginfo/meds/a604008.html

      Medically reviewed by Alan Carter, Pharm.D. — By Suzy Davenport and Kristina Iavarone — Updated on October 25, 2022

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      © 2004-2022 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.

      Generic Cialis: Options, Side Effects, and How It Compares

      Tadalafil is a generic version of the prescription drug Cialis. Doctors presribe it to treat erectile dysfunction and benign prostatic hyperplasia. It helps relieve erectile dysfunction by increasing blood flow to the penis.

      Generic Cialis is called tadalafil, which is the active ingredient in Cialis. Cialis is Food and Drug Administration (FDA) approved to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BHP). Generic tadalafil became more widely available after 2018.

      According to the FDA , generic medications provide the same benefits as brand-name drugs. Generic medications are considered against the same standards as brand-name versions to make sure that they reach the same level of:

      Usually, generic drugs aren’t available until the expiration of the brand name’s patent. Eli Lilly and Company’s patent for Cialis expired in 2018, opening the market to generic competitors.

      Keep reading to learn everything you need to know about generic Cialis.

      Tadalafil, or generic Cialis, is most commonly used to treat erectile dysfunction (ED). However, it’s also used to treat benign prostatic hyperplasia (BPH) and pulmonary arterial hypertension.

      Along with other medications used to treat ED, Cialis and generic tadalafil are only available by prescription.

      Tadalafil, like other phosphodiesterase type 5 (PDE5) inhibitors, can interact dangerously with nitrate-based medications, such as Imdur and Nitrostat. This includes nitrates used to treat heart conditions and high blood pressure.

      Generic versions of tadalafil that are FDA-approved are just as effective as Cialis. The FDA provides a rigorous inspection process to make sure companies selling these generic drugs undergo good manufacturing processes and that their drugs provide the same clinical benefits.

      FDA-approved tadalafil and Cialis are cleared for treating ED and both drugs are PDE5 inhibitors that work in the same way — by dilating blood vessels in order to increase blood flow to the penis.

      While the results are very similar, one of the biggest differences between the two is the price. Generic tadalafil pills are often less than half the price of Cialis.

      A 2019 study found that from 2012 to 2017, the median price of Cialis jumped from $127 to $365 for 30 tablets. Generic brands start at around $100 for 30 tablets.

      Price depends on the strength of the dose per pill and the pharmacy you’re buying it from. Coupons and discounts may be available. Cialis and tadalafil can both be bought online. More information can be found here.

      Finding generic tadalafil

      Keep in mind that not all brands of generic tadalafil are FDA approved. You can use the search tool on the FDA website to find an up-to-date list of approved brands.

      Tadalafil falls into a category of drugs called PDE5 inhibitors.

      When you become sexually aroused, the nerve terminals and blood vessels in your penis release a molecule called nitric oxide (NO) . NO activates a series of chemical reactions that increase blood flow to your penis by relaxing your blood vessels.

      Tadalafil and other PDE5 inhibitors like Viagra block an enzyme called PDE5. By inhibiting PDE5, nitric oxide can be more effective at relaxing blood vessels in the penis and increasing blood flow. This ultimately results in a stronger erection.

      However, both psychological and physiological factors can disrupt the sequence of reactions needed to achieve an erection. For PDE5 inhibitors to work, you still need to be sexually aroused. If your ED is caused by psychological factors, PDE5 inhibitors won’t help treat ED.

      Tadalafil is thought to help treat symptoms of BPH by relaxing the muscles in your prostate and bladder. It helps improve symptoms of pulmonary arterial hypertension by relaxing the blood vessels in your lungs.

      Tadalafil is taken orally in the form of tablets. The strength of these tablets generally ranges from 2.5 to 20 milligrams (mg).

      Tadalafil tablets can either be taken once per day or as needed.

      If you’re taking them once per day, your doctor will typically start you on a dose of about 2.5 mg and adjust based on how well it’s working for you and whether you’re experiencing any side effects. Avoid taking more than one tablet per day.

      You should take the tablets at the same time each day, so you have consistent levels of the medication in your system. Since the medication is always in your system, you have the ability to get an erection without planning ahead of time. You can have sex at any time.

      When used on an as-needed basis, your doctor will likely start you at about 10 mg per day. You can have sex about 30 minutes after taking the tablet.

      A typical dose of tadalafil to treat BPH is 5 mg per day.

      You’ll need a prescription to get generic tadalafil. There are several options for how you can get generic Cialis, including starting with talking with your doctor. You can meet with them and discuss your symptoms, and they will prescribe tadalafil for you.

      You can also consider the following telemedicine options:

      Hims: You’ll complete an online questionnaire and consult with a licensed medical professional in your state. They will evaluate you to determine whether tadalafil is right for you. If so, tadalafil will be shipped from a licensed pharmacy in discreet packaging to your home. Costs are not listed upfront on Hims’ website.

      Lemonaid Health: You’ll complete an online questionnaire and consult with a licensed medical professional (a nurse practitioner or doctor) in your state. They will evaluate you to determine whether tadalafil is right for you. If so, tadalafil will be shipped from a licensed pharmacy in discreet packaging to your home. Lemonaid Health’s website directly states that the first order of tadalafil will cost $60.

      Roman: You’ll complete an online questionnaire and consult with a licensed medical professional in your state. They will evaluate you to determine whether tadalafil is right for you. If so, tadalafil will be shipped from a licensed pharmacy in discreet packaging to your home. Costs are not listed upfront on Roman’s website.

      The side effects of generic tadalafil are the same as Cialis. There are many potential side effects, and the following list isn’t comprehensive. If you notice anything else concerning after starting tadalafil, talk with your doctor.

      Common side effects of tadalafil

      Some of the most common side effects of Cialis and tadalafil are:

      Serious side effects of tadalafil

      Tadalafil can cause a number of more serious side effects that require medical attention, such as:

      • priapism (a painful and prolonged erection that lasts more than 4 hours)
      • vision problems such as:
        • trouble differentiating between colors
        • loss of vision in one or both eyes
        • seeing blue when looking at objects

        Relatively rare side effects of tadalafil include:

        • blurred vision
        • confusion
        • jaw pain
        • slow or fast heart rate
        • spontaneous erections
        • sweating
        • vomiting
        • diarrhea
        • unusual tiredness
        • cold sweats