Tadalafil (Cialis)
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Tadalafil - Generic Cialis
Used for Benign Prostatic Hyperplasia, Erectile Dysfunction
Tadalafil (Cialis) is taken by mouth either as needed before sexual activity or once daily for erectile dysfunction (ED). It may also be taken once daily to treat symptoms from an enlarged prostate (benign prostatic hyperplasia, or BPH).
How Tadalafil (Cialis) works
Tadalafil (Cialis) is a phosphodiesterase-5 enzyme (PDE-5) inhibitor. PDE-5 is an enzyme in your body that breaks down the molecules that normally cause an erection. When it blocks PDE-5, tadalafil helps an erection occur by allowing smooth muscle in the penis to relax and the penis to fill with blood.
While it’s not fully established how tadalafil helps treat symptoms of BPH, researchers propose that the medication increases blood flow to the pelvis and helps relax the smooth muscle found in prostate tissue. Despite uncertainty as to why it works, there exists sound data supporting a benefit in men with BPH, and it is approved by the FDA to treat men with this condition.
Typical dosing for Tadalafil (Cialis)
Erectile dysfunction (taken as needed): The typical starting dose is 10 mg by mouth about 30 minutes before sexual activity up to once per day as needed. Your provider will adjust your dose based on your response. The maximum dose is 20 mg once per day.
- Erectile dysfunction (taken daily): The typical dose is 2.5 mg or 5 mg by mouth at the same time every day, without regard to timing of sexual activity. Your provider will adjust your dose based on your response.
- Benign prostatic hyperplasia alone or with erectile dysfunction: The typical dose is 5 mg by mouth at the same time every day.
Dosing for those with impaired kidney function.
Dosing for those with impaired kidney function. Inform your provider if you have impaired kidney function. For those with a creatinine clearance less than 30 mL/min or on hemodialysis: The maximum dose is 5 mg not more than once in every 72 hours.
mensRxplus Recommendations:
- Tadalafil can be taken with or without food.
- For those taking tadalafil daily, it is recommended to take at the same time every day.
- Choose a time that works best for you and be consistent.
- Don’t take more than one dose of tadalafil unless instructed by your provider.
- Doing so could lead to increased side effects like low blood pressure, dizziness, and vision problems, and increased risk of priapism.
- If you get muscle or back pain with tadalafil, it should get better in about 2 days. Talk to your provider if your symptoms don’t improve.
Side Effects
The following side effects may lessen after your body adjusts to taking the medication. Note, side effects are often less common or less noticeable with the daily dosing because this involves taking a lower dose of the medication. We have good information about side effects since this medication has been around for many years and is popular. Over 20 million monthly prescriptions for PDE5-Inhibitors like tadalafil are prescribed yearly in the US.
Who should not take Cialis?
Not recommended if you’ve had a heart attack in the past 3 months, or a stroke or heart failure in the past 6 months Can’t be used if you’ve recently taken nitrates like isosorbide mononitrate (Monoket) or nitroglycerin (Nitrostat).
Common Side Effects
Once-daily use of tadalafil (Cialis) (for ED or BPH):
- Headache (3-6%)
- Runny nose, sore throat, and other symptoms of the common cold (3-6%)
- Indigestion (4-5%)
- Stomach upset (3-5%)
- Back pain (3%)
As-needed use of tadalafil (Cialis) (for ED):
- Headache (11-15%)
- Indigestion (4-10%)
- Back pain (3-6%)
Serious Side Effects
Contact your healthcare provider or go to the emergency department immediately if you experience any of the following:
- Priapism – an erection lasting for more than 4 hours
- Vision loss
- Dangerously low blood pressure: feeling faint or weak, dizziness, blurry vision, feeling confused
See detailed warning section. (link to warnings)
Frequently Asked Questions
When taking tadalafil for ED, you need to take this medication at least 30 minutes before sexual activity. But it might take 1-2 hours for the full effects of this medication to kick in. Taking a lower dose tadalafil daily might allow for more spontaneity because you don’t have to time the dose before sexual activity. If you’re taking tadalafil (Cialis) for BPH, you’ll typically notice your symptoms improving within 1 to 2 weeks of starting this medication.
Tadalafil can work for up to 36 hours after you take it. But this doesn’t mean that the erection will last the entire time. It just means that you might be able to achieve more than one erection within this time frame without having to take another dose of tadalafil (Cialis). For this reason it is nicknamed “the weekend pill.” Remember, if an erection lasts for longer than 4 hours, seek emergency medical care as this can lead to permanent damage to the penis.
Take tadalafil as prescribed by your provider. If you’re taking tadalafil as-needed for ED, you should only take one dose per day. The effects of tadalafil should last for up to 36 hours after a dose. Taking this medication more often can increase the amount of drug in your system and raise your risk for serious side effects, such as priapism or vision changes. Instead of taking more than one pill in a day, consider discussing a different dosing option with your provider.
Alcohol can make it harder for you to get and/or maintain an erection, which might worsen ED. Alcohol also slightly lowers your blood pressure, so when combined with tadalafil men have a greater chance of headache and dizziness.
Warnings
Tadalafil (Cialis) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart problems
Risk factors: Existing heart condition | Recent heart attack or stroke in past 6 months | High or low blood pressure
Tell your provider if you have any heart conditions before starting tadalafil (Cialis). Sexual activity isn’t recommended for people with certain heart-related conditions, such as very serious heart failure. Tadalafil (Cialis) hasn’t been studied in people who have certain conditions, such as recent heart attacks or strokes. If you have a heart condition, talk with your provider about whether tadalafil (Cialis) is safe for you.
Hearing loss
Some people who took tadalafil (Cialis) reported experiencing hearing loss. This could happen along with ringing in the ears (tinnitus) and dizziness. Go to the emergency room or call your provider right away if you notice changes in your hearing in one or both ears.
Prolonged erection
Risk factors: Medical conditions that affect the penis | Sickle cell anemia | Multiple myeloma | Leukemia
Rarely, some people who took tadalafil (Cialis) reported having an erection that lasted for more than 4 hours (priapism). If not treated in time, this can lead to permanent damage to your penis. You’re at higher risk for these side effects if you have other conditions affecting your penis such as peyronie’s disease, or if you have sickle cell anemia, multiple myeloma, or leukemia. Seek medical care immediately if you have an erection that lasts longer than 4 hours.
Vision changes
Risk factors: Age 50 years or older | “Crowded” optic disc | Blood vessel problems in the
eye
If you suddenly notice changes in your vision in one or both eyes, go to the emergency room or call your provider right away. Although rare, tadalafil (Cialis) can cause permanent eye damage. If your provider has told you that you have a “crowded” optic disc, you might be at higher risk for vision changes with tadalafil (Cialis). Tell your provider about your full medical history before taking tadalafil (Cialis).
Low blood pressure
Risk factors: Taking alpha blockers | Taking medications for high blood pressure or chest pain (angina) | Drinking alcohol
If you’re taking alpha blockers or medications for high blood pressure with tadalafil (Cialis), your blood pressure may drop too low. Some medications like ritonavir (Norvir) can affect how tadalafil (Cialis) is broken down in your body, which can lead to having too much of it in your system. This can lead to more side effects, like low blood pressure. Your provider might ask you to check your blood pressure regularly if you’re taking these other medications. Be very careful getting up from a sitting or lying down position since this can make you feel dizzy and more likely to fall. Drinking alcohol can also cause low blood pressure. Avoid or lower your alcohol consumption when taking tadalafil (Cialis). You should never take tadalafil (Cialis) when taking nitrate medication for chest pain (angina) because it can cause your blood pressure to suddenly drop to unsafe levels.
Interactions with other medications
Risk factors: Age 65 years or older | Liver problems | Kidney problems | Taking nitrate medications | Taking blood pressure medications | Taking alpha blockers | Taking certain antifungals or antivirals
Tadalafil (Cialis) can have serious interactions with certain medications. It’s important that you tell your provider about all the medications you’re taking before you start tadalafil (Cialis). For example, you shouldn’t take tadalafil (Cialis) with nitrate medications because this combination can cause your blood pressure to drop dangerously low. If you’re taking other blood pressure medications, your provider might not recommend tadalafil (Cialis) until your blood pressure is under control. Taking tadalafil (Cialis) with medications, like oral azole antifungals and ritonavir (Norvir), can put you at higher risk for side effects, such as headaches, flushing, and vision changes.
For those with a creatinine clearance less than 30 mL/min or on hemodialysis the maximum dose is 5 mg not more than once in every 72 hours.
Contraindications
Do not take tadalafil if you are:
- Taking a nitrate medication for chest pain (angina)
- Taking guanylate cyclase (GC) stimulators, such as Adempas (riociguat)
Watch out for the fake stuff!
You could encounter a Cialis counterfeit while clicking on emails or shopping online. Counterfeit medications have ingredients that differ, which may result in a pill that does not work or has other side effects. You want your medications from a legit US pharmacy. mensRxplus providers only prescribe through established US pharmacies to ensure the quality of medication that our patients receive. For the tadalafil (Cialis) to be legit, look for:
- A prescription from a healthcare provider is always required
- A U.S. address and phone number are listed on website
- A licensed pharmacist is available for questions
- The pharmacy is licensed with a state board of pharmacy
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