Cialis

Don't let erectile dysfunction hold you back with Cialis

Also available as generic Tadalafil, Cialis is a popular erectile dysfunction treatment that works well on first use and has a long-lasting effect.

Cialis
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Information

Reviewed by Dr Yasmin Aghajan, MD

Information last reviewed 07/13/19

About

What is Cialis?

Cialis comes in yellow, film-coated and almond-shaped tablets. Tadalafil was approved by the FDA in 2003 for the treatment of ED, but can also be used to treat pulmonary arterial hypertension (a condition caused by changes to the pulmonary arteries which become thick and stiff) and benign prostatic hyperplasia (a non-cancerous condition in men where the prostate gland is enlarged, causing urination problems). It should only be taken under medical supervision due to its potentially serious side effects.

How does Cialis work?

Cialis helps to relax the blood vessels in the penis, which in turn increases blood flow into the penis. This helps men get an erection when they are sexually stimulated. Indeed, an erection of the penis occurs when the penis fills with blood, which happens because the blood vessels that bring blood flow to the penis dilate (become larger), thereby increasing the blood supply. Tadalafil does not help with sexual arousal and does not work if you are not sexually aroused. It only helps to facilitate the blood flow to the penis so that an erection can occur.

Ingredients

Active ingredients

Each Cialis tablet contains the active substance - tadalafil - at a concentration of 2.5, 5, 10 or 20mg. Note that doctors at Medzino only supply tablets of 2.5mg. Tadalafil belongs to the group of medicines called phosphodiesterase type 5 inhibitors.

Inactive ingredients

Cialis also contains the following inactive ingredients: croscarmellose sodium, hydroxypropyl cellulose, hypromellose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

Which ingredients can cause an allergic reaction?

Cialis does not commonly cause severe allergic reactions unless specifically allergic to the active ingredient Tadalafil. However, it does also contain lactose monohydrate which is not suitable for people with lactose intolerance. If you are lactose intolerant, you may wish to avoid this medication.

Dosage

Cialis dosage

Dosage will vary depending on the frequency of your sexual activity. For example, Cialis 10mg or 20mg is for use as needed, taken prior to anticipated sexual activity, and not for continuous daily use.

How to take Cialis

Cialis tablets are to be taken orally (by mouth) exactly as your physician has told you. Always check with your physician or pharmacist if you are not sure. Swallow the whole tablet with some water, with or without food.

Avoid drinking too much alcohol when taking Cialis as this might cause headache, dizziness, increased heart rate, or low blood pressure.

Cialis daily

For men who anticipate having sexual intercourse two or more times a week, physicians may prescribe Cialis 2.5mg for daily use. In this case, a 2.5mg tablet should be taken once a day at approximately the same time of the day, without necessarily taking into account the timing of sexual activity. This will allow men to obtain an erection at any point of the day within 24 hours. If used on a daily basis, do not take Cialis 2.5mg more than once a day. If you miss a dose, take it as soon as you remember, but do not take it more than once a day. The Cialis dose for once daily use may be increased to 5mg based on individual efficacy and tolerability.

How to take Cialis daily

Cialis daily (2.5mg - 5mg) tablets are to be taken orally (by mouth) exactly as your physician has told you. Always check with your physician or pharmacist if you are not sure. Swallow the whole tablet with some water, with or without food. A 2.5mg tablet should be taken once a day at approximately the same time of the day, without necessarily taking into account the timing of sexual activity. This should allow men to obtain an erection at any point of the day within 24 hours. If used on a daily basis, do not take Cialis 2.5mg more than once a day. If you miss a dose, take it as soon as you remember, but do not take it more than once a day. The Cialis dose for once daily use may be increased to 5mg based on individual efficacy and tolerability.

Side Effects

Side Effects

Common side effects include:

  • Headache
  • Indigestion (Dyspepsia)
  • Back pain
  • Muscle pain (Myalgia)
  • Nasal congestion
  • Flushing
  • Pain in limb

These side effects usually go away after a few hours. Back pain and/or muscle aches usually occur 12 to 24 hours after taking Cialis and usually go away after 2 days. In case symptoms persist or cause significant distress, call your healthcare provider.

Rare but serious side effects include:

  • Priapism (erection that won’t go away)
  • Color vision changes (difficulty in seeing the color blue and telling the difference between blue and green)
  • Sudden loss of vision in one or both eyes (Nonarteritic anterior ischemic optic neuropathy)
  • Sudden loss or decrease in hearing

If your erection lasts more than 4 hours, get immediate medical help as this might cause significant and lasting damage to your penis, including the inability to have erections. Furthermore, you are slightly more likely to develop NAION if you suffer from heart disease, diabetes, high cholesterol, other eye problems, high blood pressure, if you are over 50, or if your smoke. If you experience any of these serious side effects, stop taking Cialis immediately and get immediate medical help.

Contraindications

Cialis is not suitable for everyone. Talk to your physician if you have or have had the following problems:

  • Allergic reactions to Cialis or any of its ingredients (rash, itching or swelling of the tongue/face/throat, difficulty breathing, severe dizziness.
  • Heart problems (angina, heart failure, irregular heartbeats, or if your have head a heart attack). If you suffer from a heart condition, it is advised that you ask your physician first if it is safe for you to engage in sexual activity to begin with.
  • Low blood pressure, or unsupervised high blood pressure
  • If you have had a stroke
  • Liver problems
  • Kidney problems, or if you require dialysis
  • Retinitis pigmentosa (rare genetic eye disease involving breakdown and loss of cells in the retina)
  • Stomach ulcers
  • Bleeding problems
  • If you have a deformed penis
  • If you have had an erection for more than 4 hours
  • Blood cell problems (sickle cell anemia, multiple myeloma, or leukemia)

Drug interactions

Cialis and other medicines can affect each other and cause your blood pressure to drop significantly to unsafe levels if taken with certain other medicines. You could get dizzy, faint, have a heart attack or stroke. Always inform your physician about any medicines that you take including prescription and non-prescription medicines, vitamins, and herbal supplements. You should take extra precautions if you take the following medicines: nitrates, alpha blockers (including Hytrin, Flomax, Cardura, Minipress, Uroxatral), medicines for high blood pressure, medicines called HIV protease inhibitors (Norvir, Kaletra), Ketoconazole (Nizoral), Itraconazale (Sporanox), Erythromycin, other medications for the treatment of erectile dysfunction.

Q&A

Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

  1. Healthline, ‘Everything you need to know about Erectile Dysfunction (ED), [website], 17 May 2017 https://www.healthline.com/health/erectile-dysfunction#incidence [last accessed 21 March 2019]
  2. RxList, ‘Cialis’, [website], 3 May 2018, https://www.rxlist.com/cialis-drug/patient-images-side-effects.htm [last accessed 21 March 2019]
  3. EMC, ‘Cialis 2.5mg film-coated tablets’, [website], 23 March 2017, https://www.medicines.org.uk/emc/product/6747/pil [last accessed 21 March 2019]
  4. Access Data FDA, ‘CIALIS tablets for oral administration’, 1 July 2008 https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021368s011lbl.pdf [last accessed 21 March 2019]
  5. WebMD, ‘Cialis’, [website],  https://www.webmd.com/drugs/2/drug-77881/cialis-oral/details [last accessed 21 March 2019]

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