Cialis is a medication approved by the Food and Drug Administration (FDA) often used to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) in males assigned at birth.
Cialis is taken as an oral tablet, either as a low dose daily medication or as a higher-dose “on-demand” medication. It is the brand name for tadalafil, a medication also used to treat ED.
Tadalafil is in a class of drugs called phosphodiesterase-5 (PDE5) inhibitors and is available in a generic form often called generic Cialis. Tadalafil has been on the market since 2018 and has the same primary ingredient as Cialis and is generally just as effective — the only difference is the price.
Pros
- lasts up to 36 hours for some people, which is longer than Viagra
- can be taken as needed or on a daily, regular basis
- daily use allows for a more spontaneous sex life
- can be taken with or without food
- helps maintain erections longer
- some users say their orgasms are more intense
Cons
- can cause headaches and muscle aches
- must be swallowed whole
- can cause indigestion
- can make you appear flushed
- not available over-the-counter (OTC)
Cialis works by increasing blood flow to the penis to help a person get and maintain an erection. It also blocks the PDE5 enzyme, which enhances the effects of nitric oxide (NO). NO activates a series of chemical reactions that increase blood flow to the penis by relaxing blood vessels.
Cialis also relaxes the smooth muscle in the prostate and the bladder. It doesn’t protect against sexually transmitted infections (STIs).
PDE5 inhibitors work by binding to an enzyme called PDE5, which normally breaks down cyclic guanosine monophosphate (GMP) molecules.
Cyclic GMP helps relax the smooth muscles within the blood vessels of your penis. This process significantly increases blood flow to these blood vessels, leading to an erection.
Cialis and other PDE5 inhibitors don’t cure ED or increase libido. Physical and psychological arousal is still necessary for the medications to help achieve and sustain an erection.
When sexually aroused, the parasympathetic nervous system activates, triggering the release of NO. The increased presence of NO is what increases the production of cyclic GMP.
ED
Cialis is primarily used to treat ED. Guidelines
BPH
Cialis and generic tadalafil are also prescribed to treat the symptoms of BPH, also known as an enlarged prostate.
Pulmonary arterial hypertension
Tadalafil is also FDA approved to treat pulmonary arterial hypertension (PAH), which is high blood pressure affecting the arteries in the lungs. The typical dose for PAH is
Adcirca is the brand name for tadalafil and is used to treat PAH.
Obtaining Cialis
Cialis and generic tadalafil are available with a prescription only. There is no OTC version, though there have been efforts in recent years to develop a nonprescription version of tadalafil.
Cialis is available as an oral tablet in several dosages, allowing individuals to take a low-dose tablet daily or a stronger dose on-demand before sexual activity.
The daily doses are available in 2.5- and 5-mg tablets. Doctors usually start their patients on the 2.5-mg dose, though 5 mg may be appropriate if needed for greater efficacy.
A daily dose of 5 mg may be too much for some people and lead to undesirable side effects.
On-demand doses are available in 10- and 20-mg doses. Doctors usually recommend starting with a 10-mg dose and moving up to 20 mg if a stronger dose is needed to achieve the desired results.
A
To get the most out of Cialis:
- With an on-demand dose, take Cialis at least 30 minutes prior to sexual activity, though understand that it could take up to 2 hours to take effect.
- Take daily doses at about the same time every day.
- Focus on managing stress.
- Maintain healthy communication with your partner.
Some of the most common side effects associated with Cialis are:
- headache
- flushing
- indigestion
- congestion
- back pain and muscle aches
Cialis is more likely to cause myalgia (muscle pain) when compared with other PDE5 inhibitors, according to a 2016 study on ED treatment published in the journal
Many Cialis or generic tadalafil users do not experience side effects, and those who do often have minor complaints that tend to go away once the drug is out of their system.
Muscle aches may last up to 2 days or so after taking your last dose.
More potential and serious symptoms include priapism, an abnormal, sometimes painful erection that lasts more than 4 hours.
Other concerning symptoms that should prompt a visit with a healthcare professional include sudden changes in vision and hearing, which occasionally occur with tinnitus and dizziness.
Unlike some other PED5 inhibitors, Cialis may be taken with or without food. It’s unlikely to have any impact on its effectiveness or side effects.
Avoid taking with high fat foods and meals
You should avoid high-fat meals when using Cialis. Too much fat may affect how well the medication works and how quickly it takes effect.
Avoid grapefruit juice
Grapefruit and grapefruit juice can enhance levels of Cialis in the bloodstream, potentially increasing negative side effects.
Avoid heavy alcohol drinking
Moderate alcohol consumption should have little effect on how Cialis works. But heavy alcohol consumption can make it difficult to achieve an erection even with an ED medication.
Know your other medications
Cialis may interact with certain medications. In particular, you should not take Cialis if you’re also taking nitrates, which are medications that widen arteries to allow greater blood flow.
Nitrates are typically prescribed to treat angina (chest pain brought on by narrowed coronary arteries) or heart failure.
When taken with nitrates or antihypertensive medications called alpha-blockers, Cialis could cause a dangerous drop in blood pressure.
Cialis may lead to similar problems when used in combination with other antihypertensive drugs.
Other classes of drugs that may interfere with Cialis include:
- antiseizure medications
- certain antibiotics
- HIV medications
- oral antifungal medications
You should also avoid taking two PDE5 inhibitors in 1 day, as this can lead to a dangerous drop in blood pressure and other serious side effects.
Cialis and generic tadalafil are equally effective. The FDA works to ensure that the generic versions of all brand-name medications provide the same clinical benefits.
The main difference between Cialis and generic tadalafil is the cost.
Though prices vary considerably depending on the manufacturer and pharmacy where you’re buying the medication from, Cialis typically costs around $365 for 30 tablets. The generic versions cost about $100 for 30 tablets.
Brand reputation and customer reviews
(Video) Cialis Vs Viagra - Which one is Better | Erectile Dysfunction Treatment | Sildenafil Vs Tadalafil
Brand reputation and customer reviews
Cialis has been a widely available medication since gaining FDA approval in 2003. The medication is marketed and distributed by the company Eli Lilly and is sold in 2.5-, 5-, 10-, and 20-mg tablets. Eli Lilly is a large pharmaceutical company and manufacturer that also sells many other popular medications like Trulicity and Taltz.
Cialis has a generally positive reputation with customers because of its effectiveness and how long-acting it can be when taken daily. Since Cialis is available through pharmacies and several online ED medication services, overall customer satisfaction ratings can vary, especially since many of these online services put their most positive reviews out front.
If you are curious about user satisfaction with Cialis, make an appointment with your doctor or specialist to see if they think you could benefit from using Cialis.
While Cialis is widely prescribed around the world, the most well-known PDE5 inhibitor is Viagra (sildenafil), which is the first medication in this class of drugs to hit the market.
In addition to Cialis and Viagra, the other PDE5 inhibitors include:
- vardenafil (Levitra, Staxyn)
- avanafil (Stendra)
These medications work best when used in combination with doing other things to support your overall health, especially those that directly impact your cardiovascular health.
In addition to PDE5 inhibitors, there are alternatives to medications some people consider, along with healthy habits. Among them are supplements and pill-free options, like:
- L-arginine, an amino acid that helps manufacture nitric oxide
- red ginseng, also known as Panax ginseng, an herb sometimes taken to lower inflammation
- acupuncture, though research has shown conflicting results
Other habits that help sexual function
Making certain lifestyle changes can help fight ED, too. This includes things like:
- getting regular exercise when possible
- quitting smoking (if you smoke)
- getting 7 to 8 hours of sleep each night
- consuming nutrient-dense foods when possible
- finding ways to manage stress
Cialis and Viagra each have their pros and cons, though the medications work similarly in the body.
Cialis has the advantage of lasting longer, with effects often lingering as long as 36 hours after taking the tablet.
Viagra usually lasts about 4 hours. Viagra is also an on-demand medication only, so the spontaneity that daily Cialis use allows is not an option with Viagra.
But Cialis is associated with muscle aches in the limbs in some users, a side effect not associated with Viagra. However, some research suggests that Viagra use may be associated with vision problems.
You can also find generic versions of both Cialis and Viagra.
Your lifestyle and personal experience with a particular medication may help you determine if Cialis, Viagra, or another PDE5 inhibitor is the right choice.
Cialis isn’t available over the counter. Your doctor has to prescribe Cialis for ED or other conditions the medication treats.
You may also be able to obtain this medication with the help of telemedicine services.
Companies like Hims and Roman offer online consultations with physicians who can prescribe ED medications that are then mailed to your home.
The cost of these online services can sometimes exceed conventional healthcare, though the convenience and discretion of this type of telemedicine service are appealing to many individuals.
Online ED treatment services
- Roman
- Hims
- Lemonaid
- Giddy
How long does Cialis last?
Taking Cialis daily will make it easier for you to get and keep an erection for as long as you regularly take the medication. If you are only taking a higher dose of Cialis as needed, the ability to get an erection could last up to 36 hours, for some people.
What are the downsides of Cialis?
Cialis can cause some side effects, including headaches, muscle aches, congestion, and indigestion.
Does Cialis last longer than Viagra?
Yes, Cialis in higher dosages can last up to 36 hours, while Viagra commonly lasts up to 4 hours. Talk with your doctor to see which medication best fits your sexual lifestyle.
Cialis, the brand version of the PDE5 inhibitor tadalafil, is one of the world’s most widely prescribed ED medications.
Generic tadalafil has been available since 2018 and has proven to be just as effective and safe as the brand name.
The drug is available in low daily doses that keep the medication in your system and allow for greater spontaneity. It’s also available in stronger, on-demand doses.
While Cialis and other ED drugs don’t “cure” the condition, they can treat the primary symptom by helping achieve and maintain erections.
If ED is affecting your life and relationship, you may want to consider trying tadalafil in some form.
It’s available by prescription only, so consult with a doctor about this and other possible ED treatments.
FAQs
How safe is taking Cialis? ›
Generally, Cialis is a safe drug. However, you need to consider the other substances you take with it and the effects the combination can cause. For example, alcohol and Cialis may interact. Excessive drinking may lead to some very serious side effects.
What is the downside of Cialis? ›The most common side effects with Cialis are: headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Men who get back pain and muscle aches usually get it 12 to 24 hours after taking Cialis.
How long will I stay hard with Cialis? ›On the other hand, the effects of Cialis last noticeably longer than the effects of Viagra, normally up to 36 hours. That's a full 1.5 days! Don't be alarmed, though: That doesn't mean you'll have an erection for 1.5 days straight. That would be an emergency, which we'll talk about soon.
Is long term use of Cialis Safe? ›A 2004 clinical trial published in the Journal of European Urology followed more than 1,000 men using various dosages of tadalafil for up to 24 months. They found no serious adverse effects to long term use of tadalafil over the course of those two years.
Is Cialis OK for your heart? ›Viagra and Cialis May Cut Risk of Early Death From Heart Disease by 25 Percent. A large new study shows that men who take erectile dysfunction medication are less likely to experience heart failure, stroke, and heart attack.
Does Cialis make you harder than Viagra? ›So to answer the above question, no, Viagra would not necessarily give a stronger erection than Cialis, and vice versa. However, Cialis will last longer and can help achieve one or more erections for up to 36 hours. This is considerably longer than Viagra, which is typically effective for 4-6 hours.
Does Cialis make you hard all day? ›Compared with other ED drugs, Cialis lasts longer, working for up to 36 hours. But that doesn't mean a continuous erection for 36 hours. It means that the medicine enhances your ability to get hard over the course of 36 hours.
How can I enhance my Cialis effect? ›- Take as directed. For as-needed dosing, take Cialis at least 30 minutes or more before sexual activity. ...
- Take as part of a lifestyle with physical activity. ...
- Communicate and stay relaxed.
Peak plasma concentrations of Cialis are reached within 30 minutes to six hours (average time two hours) of a dose. Effects of 'as needed' Cialis last for up to 36 hours. The recommended starting dose for once-daily Cialis for ED is 2.5mg; once daily Cialis for BPH, 5mg; and 'as needed' Cialis, 10mg.
Will Cialis make me rock hard? ›It's worth noting that, while both Cialis and Viagra will help you achieve a harder erection, this only works if you suffer from erectile dysfunction. If you can already achieve a strong erection without the use of ED treatments, neither Viagra nor Cialis will make you harder.
Why am I not getting hard on Cialis? ›
But the main reason why Cialis and other medications don't work is the lack of sufficient blood flow to the penis no matter what the cause. For the most part, erections are all about having enough blood getting to the penis to result in an erection.
How should I take Cialis for best results? ›Cialis is taken orally before sexual activity, not more than once daily. Cialis may be taken with or without food. In some patients, the dose strength and maximum frequency of use may be adjusted. For more detailed information consult with your health care provider.
Does 5mg of Cialis do anything? ›CIALIS 5 mg is used to treat adult men with: erectile dysfunction. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity. CIALIS has been shown to significantly improve the ability of obtaining a hard erect penis suitable for sexual activity.
Does Cialis raise blood pressure? ›Taking Cialis can cause changes in blood pressure, including high blood pressure. Blood pressure changes weren't common in people taking Cialis in clinical trials. Low blood pressure was more likely to occur than high blood pressure, but both are possible. These changes tend to be mild.
Why do bodybuilders take Cialis? ›What is known is that the medication, as a vasodilator, promotes better blood circulation throughout the body, not just in the penile region. With this, those who ingest the medicine, theoretically, would gain more energy and resistance.
Is taking 5 mg of Cialis daily OK? ›The drug comes in low-dose versions that can be taken daily. This means you can have sex at any time, rather than needing to take a pill from time to time as needed like other ED brands. The starting dose for daily-use Cialis is 2.5 milligrams (mg). If that doesn't work, you can increase your daily dose up to 5 mg.
Is Cialis hard on the liver? ›Tadalafil has not been linked to cases of acute liver failure, chronic hepatitis or vanishing bile duct syndrome. There is no known cross sensitivity between tadalafil and the other PDE5 inhibitors currently in use in the United States, but switching to another PDE5 inhibitor should be done with caution.
Does Cialis increase blood flow everywhere? ›Cialis' Effect on Blood Pressure
Because tadalafil and other PDE5 inhibitors have vasodilating effects — meaning they open blood vessels — they make it easier for blood to flow, which can lower blood pressure.
- Sildenafil (Viagra). This medication is most effective when taken on an empty stomach one hour before sex. ...
- Vardenafil (Levitra, Staxyn). This medication also is most effective when taken one hour before sex and can be taken with or without food. ...
- Tadalafil (Cialis). ...
- Avanafil (Stendra).
Generally, it occurs in males between the ages of 12 and 35, although it is possible for men of any age to experience ejaculation. As men age, the frequency of ejaculation will usually decrease; however, it is important to note that some men may continue to ejaculate regularly into their later years.
Can you stop taking Cialis abruptly? ›
Also, do not stop taking this medicine without checking first with your doctor. This medicine comes with a patient information leaflet.
What does Cialis do to a woman? ›However, just like there is an off-label use of Viagra (sildenafil; see Important Safety Information) for women, some healthcare providers may suggest Cialis if you are struggling with female sexual dysfunction. Similar to Cialis for men, researchers think tadalafil may increase blood flow to the genital area in women.
Is 20mg Cialis equal to 100mg Viagra? ›It may cause longer-lasting side effects.
Is 20mg Cialis equal to 100mg Viagra in terms of efficacy? 20mg is the maximum dose of Cialis and 100mg is the maximum dose of Viagra, meaning your healthcare provider may suggest that you use 100mg of Viagra if you're prescribed Cialis and want to change medications.
Because daily-use Cialis is taken at a lower dosage than as-needed CIalis, you may have a reduced risk of experiencing side effects from your medication. Many side effects are less common when Cialis is used daily.
When is the best time to take Cialis morning or night? ›For erectile dysfunction, take 1 tablet at least 30 minutes before you want to have sex. If you are taking tadalafil for prostate enlargement, you can take your tablet in the morning or evening, but it's best to take it at the same time each day.
Is 10 mg Cialis daily too much? ›If you take Cialis daily, the maximum dosage is 5 mg per day. Taking doses of Cialis above the recommended limit could lead to serious side effects, such as dangerously low blood pressure or priapism (a painful erection lasting 4 hours or longer).
Is 10mg Cialis strong? ›It's known as the 'standard dose': 10mg Cialis is taken as you need it (on demand), at least half an hour before sex. It can last for up to 36 hours. This dosage works for most people who try it and has a lower risk of Cialis side effects than the higher on demand dose, 20mg.
Is 10mg of Cialis a day too much? ›For treatment of erectile dysfunction (as needed): Adults—10 milligrams (mg) as a single dose, no more than once a day, taken 30 minutes before you think sexual activity may occur. Your doctor may adjust your dose as needed. Children—Use is not recommended.
Can Cialis increase testosterone? ›In this study, we aimed to evaluate the effect of tadalafil 5 mg once daily on the level of testosterone in men with ED accompanied by the MetS. Our results showed that 5 mg tadalafil once daily improves ED by increasing TT levels in men.
Why is my 20 mg Cialis not working? ›The most common reasons why Cialis may not have worked are incorrect use or inadequate trial. It is important to understand that Cialis may not work after the first dose. It is advisable to try at least 8-10 doses before getting concerned about whether or not Cialis is working.
Does tadalafil increase size? ›
found no difference in penile size between pre and postoperative measurements with the use of full dose PDE5-I on demand (8). We found a significant decrease in all penile measurements in control patients (not using Tadalafil) at 3rd postoperative month when compared with preoperative measurements (p = 0.001).
Does caffeine interfere with Cialis? ›Coffee and other sources of caffeine are not known to interact with Cialis. It should be safe to consume coffee and caffeine while taking this drug. According to one study , consuming caffeine may lower the risk of erectile dysfunction (ED).
Does Cialis give you a better pump? ›From my research, the general consensus is that Cialis is a pretty effective pre-workout supplement. Tadalafil is capable of relaxing blood vessels and increasing blood flow in effect, which can enhance your overall energy and give you some pretty good pumps.
What is the success rate of Cialis? ›According to Harvard Men's Health Watch, the active ingredients used in Cialis, Viagra, Stendra and Levitra are only fully effective around 70 percent of the time in the healthy men that take them, meaning that many men still have erection issues even with the use of medication.
Will Cialis keep me hard? ›To treat erectile dysfunction (ED), your doctor may have you take Cialis only as needed before sexual activity. (See the “Cialis dosage” section below 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.
Is Cialis less harmful than Viagra? ›Overall, Cialis and Viagra have nearly identical side effects -- something that isn't a surprise, as both medications are very similar. However, because of the longer half-life of Cialis, its adverse effects may persist for longer.
Does Cialis keep you hard all day? ›Compared with other ED drugs, Cialis lasts longer, working for up to 36 hours. But that doesn't mean a continuous erection for 36 hours. It means that the medicine enhances your ability to get hard over the course of 36 hours. As a treatment for ED, you can take tadalafil one of two ways (Rew, 2016):
What would cause Cialis not to work? ›But the main reason why Cialis and other medications don't work is the lack of sufficient blood flow to the penis no matter what the cause. For the most part, erections are all about having enough blood getting to the penis to result in an erection.
At what age does a man stop ejaculating? ›While some men may experience premature ejaculation, others may experience difficulty ejaculating at all. While there is no definite age at which male ejaculation ceases, it has been suggested that it may happen when a man reaches his late 40s or early 50s.
Is there a better pill than Cialis? ›Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects.
What is the number 1 ED pill? ›
Overall, tadalafil is the best ED medication on the market if you're looking for long-lasting relief from erectile dysfunction. It's also a great option if you prefer a once-daily pill to the as-needed dosage form of other ED medications.