Cialis (tadalafil)

Cialis is a brand-name prescription drug. It’s approved by the Food and Drug Administration (FDA) to treat the conditions below in adult males.*

• Benign prostatic hyperplasia (BPH). BPH is a condition that happens when the prostate becomes enlarged. (The prostate is a gland found in males. It’s located below the bladder and in front of the rectum.) Doctors can prescribe Cialis to treat symptoms of BPH, such as frequent or urgent urination. For this use, Cialis may be prescribed alone or in combination with finasteride (Proscar).
• Erectile dysfunction (ED). ED is the inability to achieve or maintain an erection firm enough for sexual intercourse. Doctors can prescribe Cialis for daily use or as needed before sexual activity.
• Both BPH and ED. Doctors can prescribe Cialis to treat BPH and ED in males who have both conditions.

For details about these conditions and how the drug treats them, see the “Cialis: Uses” section below.

* Sex and gender exist on spectrums. In this article, use of the term “male” refers to sex assigned at birth.

The following table provides key facts about Cialis.

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Cialis is a brand-name medication. It contains the active drug tadalafil, which also comes in a generic form. A generic is an identical copy of the active drug found in a brand-name medication.

The Food and Drug Administration (FDA) ensures that generic drugs are as safe and effective as their original drug. Generics tend to be less expensive than brand-name drugs.

If you’d like to know about using the generic version of Cialis, ask your doctor or pharmacist. They can tell you if the generic medication comes in forms and strengths recommended for your condition.

Doctors may prescribe drugs other than Cialis for your condition. Certain drugs may work better for you than others.

Cialis is used to treat benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Here are summaries of other drugs that doctors sometimes prescribe for BPH and ED.

To learn more about alternatives to Cialis, read below. Your doctor can tell you about other medications that could be prescribed for your condition.

For more information about some alternatives of Cialis, view the following articles:

• Cialis vs. sildenafil (Viagra)
• Cialis vs. vardenafil (Levitra)*

* Brand-name Levitra has been discontinued. However, its generic form, vardenafil, is still available for use.

Below, you’ll find dosages that are commonly recommended for Cialis. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Most often, doctors start by prescribing a low dosage of Cialis. Then, they’ll change the dosage over time to an amount that’s right for the condition being treated. Doctors typically prescribe the smallest dosage that gives the desired outcome.

The dosage of Cialis that your doctor prescribes will depend on factors such as:

• any health conditions you have, including kidney or liver problems
• other medications you’re taking
• the condition you’re using Cialis to treat and the severity of the condition

Cialis is available as follows.

• Form: oral tablet
• Strengths: 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg

Recommended dosages for Cialis are described below.

Cialis is approved to treat benign prostatic hyperplasia (BPH) in adults.

Cialis’s recommended dosage for BPH is as follows.

• Dosage: 5 mg
• Frequency: once daily

Cialis is approved to treat erectile dysfunction (ED) in adults. Doctors can prescribe Cialis for daily use or as needed before sexual activity.

Cialis’s recommended daily dosage for ED is as follows.

• Dosage range: 2.5 mg to 5 mg
• Frequency: once daily, regardless of the timing of sexual activity

Cialis’s recommended dosage when it’s taken as needed for ED is as follows.

• Dosage range: 5 mg to 20 mg
• Frequency: one dose at least 30 minutes before sexual activity, with a maximum of one dose per day*

* Cialis may continue working to treat ED for up to 36 hours after a dose is taken. In this case, you may not need to take the drug every day. Your doctor can advise on the frequency of Cialis that’s best for you.

Cialis is approved to treat BPH and ED in adults with both conditions.

Cialis’s recommended dosage for BPH and ED is as follows:

• Dosage: 5 mg
• Frequency: once daily, regardless of the timing of sexual activity

Below are some things to consider about Cialis’s dosage.

• Missing a dose. If you typically take Cialis daily and you miss a dose, take it as soon as you remember. However, you shouldn’t take more than one dose per day. So, if you realize you missed yesterday’s dose, just skip it. Then continue your usual dosing schedule. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Length of treatment. Doctors typically prescribe Cialis as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition. However, when used in combination with finasteride (Proscar) for BPH, doctors usually prescribe Cialis for a short time. In this case, your doctor may prescribe Cialis for a maximum of 26 weeks. After that, you’ll likely stop taking Cialis and continue taking finasteride alone.

As with most drugs, it’s possible to have side effects with Cialis. These can include some mild side effects, but also some serious ones.

To learn more about Cialis’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

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

Mild and serious side effects of Cialis are listed in the table below. This table does not include all of Cialis’s possible side effects.

* This is not a complete list of Cialis’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† An allergic reaction is possible after taking Cialis. However, this side effect wasn’t reported in clinical studies. To learn more about allergic reaction, see below.

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

Serious side effects from Cialis aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Here are some common questions about Cialis and brief answers to them. If you’d like to know more about these topics, ask your doctor.

How long the effect of Cialis lasts depends on the reason you’re taking the drug and how often you’re taking it.

If you take Cialis daily, the drug is expected to help manage your condition for as long as you’re taking it.

The length of its effects may be different if you take Cialis as needed before sexual intercourse. The drug may continue working to treat erectile dysfunction (ED) for up to 36 hours after a dose is taken.

However, be aware that Cialis may cause priapism in rare cases. Priapism is a painful erection that lasts longer than 4 hours. People with certain conditions may have an increased risk of this side effect. These conditions include:

• blood cell problems, such as sickle cell anemia
• blood cancers, such as leukemia or multiple myeloma
• conditions that affect the shape of the penis, such as having a bent penis or Peyronie’s disease

Before taking Cialis, tell your doctor if you have any of the conditions listed above. They can recommend whether Cialis is a safe treatment option for you.

Note that priapism is a medical emergency and should be treated right away. If you have an erection that lasts longer than 4 hours while taking Cialis, call 911 or your local emergency number immediately.

Cialis affects each person differently. It’s not possible to predict whether you can avoid any of Cialis’s side effects altogether.

However, having certain conditions can increase your risk of side effects with Cialis. So, you may be able to reduce your risk of certain side effects by telling your doctor if you have these conditions. They can determine whether it’s safe for you to take Cialis or if a different treatment could be used instead.

For more information about these conditions, see the “Cialis: Precautions” section below.

Below are a few ways you may be able to enhance Cialis’s effect for the conditions it treats: benign prostatic hyperplasia (BPH) and ED.

For BPH, your doctor may prescribe Cialis in combination with other treatments. An example is finasteride (Proscar). These other treatments can also reduce symptoms of BPH, which may help enhance the effects of Cialis.

For ED, the manufacturer of Cialis hasn’t recommended any additional treatments that could enhance the drug’s effect.

However, keep in mind that ED can be caused by many factors. Examples include:

• other health conditions, including high cholesterol, diabetes, and thyroid disease
• use of cigarettes, alcohol, or illegal drugs
• medications, including antidepressants such as sertraline (Zoloft)

So, you may be able to enhance Cialis’s effect by managing these other causes of ED. For example, you may find that reducing your cholesterol levels helps ease the symptoms of your ED. Or, if your antidepressant is causing ED, your doctor could switch you to a different drug instead.

To learn more about how to enhance the effects of Cialis, talk with your doctor or pharmacist.

No, Cialis will not make the penis bigger.

Cialis can help you achieve and maintain an erection. An erection happens when an extra supply of blood enters the penis. This blood becomes trapped in the penis and helps it hold the erect shape. The penis may appear larger during an erection than it does when it’s flaccid (soft). However, this process doesn’t truly affect the size of the penis.

If you have questions about what to expect with Cialis, talk with your doctor or pharmacist.

Yes, if your doctor recommends it.

Taking two 5-milligram (mg) tablets of Cialis is the same as taking one 10-mg tablet. If your doctor prescribes 10 mg of Cialis, you can take two 5-mg tablets to reach this dose.

However, it’s important that you only take the dosage of Cialis your doctor prescribes. If they haven’t prescribed 10 mg of Cialis, it’s best not to take two 5-mg tablets.

If you’re prescribed 5 mg of Cialis but feel that this dose isn’t effective for treating your condition, talk with your doctor. They’ll advise whether you can increase your dosage to 10 mg.

Cialis is approved to treat benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). To learn more about these conditions, see the “Cialis: Uses” section below.

Cialis belongs to a class of drugs called phosphodiesterase 5 (PDE5) inhibitors. The drug works by blocking an enzyme (type of protein) in the walls of blood vessels. This enzyme is called PDE5. In doing this, Cialis helps treat ED by relaxing blood vessels and increasing blood flow to the penis. As a result, the penis can achieve and maintain an erection.

The way Cialis works to treat BPH isn’t known for certain. The drug is thought to help relax muscles in the prostate and bladder. This helps reduce pressure on the bladder, which eases the symptoms of BPH.

How long it takes Cialis to start working depends on the reason you’re taking the drug and how often you’re taking it.

For instance:

• If you’re taking Cialis daily for BPH or ED, it may take several doses for the drug to reach its maximum effect. If you’re taking Cialis 5 milligrams (mg) daily, the drug is likely to start working to ease your symptoms within 1 week after you start taking it.
• If you’re taking Cialis as needed before sexual intercourse, you’ll likely be able to achieve and maintain an erection within 2 hours of taking the drug. Keep in mind that Cialis may continue working to treat ED for up to 36 hours after a dose is taken.

Prescription drugs, such as Cialis, are approved by the Food and Drug Administration (FDA) to treat certain conditions. Doctors sometimes prescribe drugs off-label for other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

The FDA has approved Cialis to treat benign prostatic hyperplasia (BPH) in adult males.*

BPH is a condition that happens when the prostate becomes enlarged. (The prostate is a gland found in males. It’s located below the bladder and in front of the rectum.)

The prostate typically begins to grow after age 40 years. As it becomes enlarged, the prostate presses on the bladder and urethra. (The urethra is the tube that carries urine from the bladder to the outside of the body.) This pressure on the bladder and urethra causes the symptoms of BPH, which include:

• frequent urination
• urgent urination
• weak urine flow
• urine leakage

For BPH, doctors may prescribe Cialis alone or in combination with finasteride (Proscar). Doctors can also prescribe Cialis to treat BPH and erectile dysfunction (ED) in males who have both conditions. For details about ED, see “Using Cialis for erectile dysfunction (ED)” below.

* Sex and gender exist on spectrums. In this article, use of the term “male” refers to sex assigned at birth.

The FDA has approved Cialis to treat ED in adult males.*

ED is the inability to achieve or maintain an erection firm enough for sexual intercourse. This condition can be caused by many factors, such as:

• other health conditions, including high cholesterol, diabetes, and thyroid disease
• use of cigarettes, alcohol, or illegal drugs
• medications, including antidepressants such as sertraline (Zoloft)

For ED, doctors may prescribe Cialis for daily use or only as needed before sexual activity. Doctors can also prescribe Cialis to treat ED and BPH in males who have both conditions. For details about BPH, see “Using Cialis for benign prostatic hyperplasia (BPH)” above.

* Sex and gender exist on spectrums. In this article, use of the term “male” refers to sex assigned at birth.

For BPH, you may take Cialis in combination with finasteride (Proscar). In this case, your doctor may prescribe Cialis for a maximum of 26 weeks. After that, you’ll likely stop taking Cialis and continue taking finasteride alone.

Doctors typically won’t prescribe Cialis for use in children. The drug is only approved for use in adults.

If you’re interested in taking Cialis, search here to find a doctor who might prescribe it. To prepare for your appointment, you can visit Healthgrades’s appointment guide for benign prostatic hyperplasia or erectile dysfunction.

Your doctor will likely recommend that you limit the amount of alcohol you drink while taking Cialis.

Both Cialis and alcohol can lower your blood pressure. So, your risk of low blood pressure is even greater if you drink alcohol while taking the drug.

If you drink alcohol, your doctor can recommend the amount that’s safe to drink while taking Cialis.

Your doctor will recommend how you should take Cialis. It’s important that you take the drug exactly as your doctor instructs.

Cialis comes as an oral tablet. You’ll take the drug by swallowing it.

Here’s a list of common questions related to taking Cialis.

• When should I take Cialis? It depends. You may take Cialis once daily for benign prostatic hyperplasia (BPH), erectile dysfunction (ED), or both. In this case, taking Cialis around the same time of day helps keep a steady level of it in your body. This helps the medication work effectively. View these medication reminder options to help avoid missing doses of Cialis. You could also set an alarm, use a timer, or download a reminder app on your phone. Or, instead of daily doses, you may take Cialis as needed to treat ED. In this case, you’ll take your dose at least 30 minutes before sexual activity.
• Do I need to take Cialis with food? You can take Cialis with food or without it.
• Can Cialis be chewed, split, or crushed? Cialis shouldn’t be chewed, split, or crushed. You’ll swallow the tablets whole.
• Is there a best time of day to take Cialis? No, there isn’t a best time of day to take Cialis. You can take the drug any time of day. However, it’s recommended to take Cialis around the same time each day if it’s prescribed for daily use.

Cialis may interact with other medications and certain foods. It’s not known to interact with any supplements.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

• Cialis and nitrates. Nitrates are used to treat chest pain. The manufacturer of Cialis advises that these drugs should not be taken together. Be sure to discuss with your doctor before taking these drugs together. Examples include:
  • nitroglycerin (Nitro-Dur, Nitrostat)
  • isosorbide mononitrate (Monoket)
  • isosorbide dinitrate (Isordil)
• Cialis and guanylate cyclase (GC) stimulators. GC stimulators are used to treat pulmonary hypertension and heart failure. The manufacturer of Cialis advises that these drugs should not be taken together. Be sure to discuss with your doctor before taking these drugs together. Examples include:
  • riociguat (Adempas)
  • vericiguat (Verquvo)
• Cialis and certain other medications. Because Cialis may interact with certain other drugs, your doctor may recommend that you don’t take it with these drugs. Examples include:
  • blood pressure drugs, including alpha-blockers such as alfuzosin (Uroxatral) and tamsulosin (Flomax)
  • certain antifungal drugs, such as ketoconazole and itraconazole (Sporanox)
  • certain antibiotic drugs, such as rifampin (Rifadin) and erythromycin
  • certain seizure drugs, such as carbamazepine (Tegretol), phenobarbital, and phenytoin (Dilantin)
  • certain HIV drugs, such as ritonavir (Norvir)
• Cialis and herbs and supplements. There aren’t any herbs or supplements known to interact with Cialis. Before taking any of these products with Cialis, talk with your doctor or pharmacist.
• Cialis and foods. Certain medications interact with foods. Examples of foods that may affect Cialis include grapefruit and grapefruit juice.

Like other medications, prices for Cialis may vary. The drug’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage

Here’s a list of things to consider when looking into the cost of Cialis.

• Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
• Need for prior authorization. Before insurance coverage for Cialis is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Cialis. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Cialis, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Cialis may be available. Visit Needy Meds to learn more and see if you’re eligible for support. Also, check out this article to learn about ways to save on prescription drugs.
• Use of a mail-order pharmacy. Cialis may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
• Availability of a generic form. Cialis comes in a generic form called tadalafil. A generic drug is an exact copy of the active drug in a brand-name medication. Generics are typically less expensive than brand-name drugs. If your doctor prescribes Cialis but you want to know about using tadalafil, talk with your doctor about which option might be better for you. Also, check your insurance plan because it might cover just one form or the other.

Cialis isn’t approved for use in females.* It’s not known if Cialis is safe to use during pregnancy.

If you have questions about taking Cialis while pregnant, talk with your doctor.

* Sex and gender exist on spectrums. In this article, use of the term “female” refers to sex assigned at birth.

Doctors aren’t sure if it’s safe to take Cialis during pregnancy. Talk with your doctor about your birth control needs with Cialis if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

Cialis isn’t approved for use in females.* It isn’t known if Cialis is safe to use while breastfeeding.

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

* Sex and gender exist on spectrums. In this article, use of the term “female” refers to sex assigned at birth.

Tell your doctor about your health history before starting treatment with Cialis. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

• Eye problems. In rare cases, Cialis may cause serious eye problems, such as vision loss. People who already have certain eye problems may have a higher risk of these side effects. Before taking Cialis, tell your doctor if you have problems with your optic nerve or retina. An example is retinitis pigmentosa. They’ll advise whether it’s safe for you to take Cialis.
• Stroke or heart problems. Cialis isn’t recommended for people who’ve had a stroke or certain heart problems. Examples include having had a heart attack in the past 90 days or heart failure in the past 6 months. Other examples include current chest pain, abnormal heart rhythm, or high or low blood pressure. It’s not known if Cialis is safe for people who have these conditions. If you have these conditions, your doctor may prescribe a treatment other than Cialis.
• Blood cell problems. Before taking Cialis, tell your doctor if you have certain blood cell problems. This includes sickle cell anemia. This condition can increase your risk of priapism (painful, prolonged erection) as a side effect. Your doctor can advise whether Cialis is a safe treatment option for you.
• Blood cancers. Before taking Cialis, tell your doctor if you have a blood cancer, such as leukemia or multiple myeloma. These conditions can increase your risk of priapism (painful, prolonged erection) as a side effect. Your doctor can recommend if Cialis is a safe treatment option for you.
• Peptic ulcers. Cialis may increase the risk of bleeding in people who have peptic ulcers. If you have this condition, talk with your doctor before taking Cialis. They can tell you if Cialis is safe to take.
• Bleeding problems. Cialis may increase the risk of bleeding in people who have bleeding problems, such as hemophilia. If you have bleeding problems, talk with your doctor before taking Cialis. They can advise whether Cialis is a safe treatment to take.
• Kidney or liver problems. If you have kidney or liver problems, be sure to tell your doctor before taking Cialis. Examples of these problems include kidney failure and liver failure. Your doctor may give you a lower dosage of Cialis than what is usually prescribed. Or they may prescribe a treatment other than Cialis.
• Mishappened penis. Before taking Cialis, tell your doctor if you have a condition that affects the shape of your penis. Examples include having a bent penis or Peyronie’s disease. These conditions can increase your risk of priapism (painful, prolonged erection) as a side effect. Your doctor can advise whether Cialis is a safe treatment option for you.
• Allergic reaction. Your doctor will likely not prescribe Cialis if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
• Pregnancy. It isn’t known if Cialis is safe to use during pregnancy. If you’d like to learn more information about taking Cialis while pregnant, view the “Cialis: Taking while pregnant” section above.
• Breastfeeding. It’s not known if Cialis passes into breast milk. If you’d like to learn more information about taking Cialis while breastfeeding, view the “Cialis: Taking while breastfeeding” section above.

To learn more about effects of Cialis that could be harmful, see the “Cialis: Side effects” section above.

For some drugs, taking more than the recommended dosage may lead to unwanted side effects or overdose. Do not use more Cialis than your doctor advises.

Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.

Here’s some information about Cialis’s expiration date, as well as how to store and dispose of the drug.

• Expiration. Your pharmacist will add an expiration date to the label on Cialis’s bottle. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source that you avoid using expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
• Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Cialis tablets should be stored at room temperature between 59°F and 86°F (15°C and 30°C). Avoid storing it in areas where it could get damp or wet, such as bathrooms.
• Disposal. It’s important to safely dispose of Cialis if you no longer need to take it and have unused medication. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps avoid causing harm to the environment. Ask your pharmacist for information about disposing of Cialis. Also, check out this page for several tips on safe medication disposal.

If you have questions about Cialis, talk with your doctor. They can help advise you on whether Cialis could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

• What should I do if I have chest pain after taking Cialis?
• Do I have any health conditions that could affect my dosage of Cialis?
• Can I increase my own dosage if Cialis doesn’t work for me?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for erectile dysfunction. This article provides information about other drugs for benign prostatic hyperplasia.

Disclaimer: Healthgrades 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.