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What is Cialis and Why is Cialis Prescribed?

Cialis is the brand name for tadalafil, a medication used to treat erectile dysfunction (ED).

Tadalafil is in a class of drugs called phosphodiesterase-5 (PDE5) inhibitors. Cialis is taken as an oral tablet either as a low-dose daily medication or as a higher-dose “on-demand” medication.

Generic Cialis, tadalafil, has been on the market since 2018. The active ingredient, tadalafil, is the same in the brand and generic forms of the drug. The only real difference between them is cost.

Tadalafil (Cialis) is used to treat erectile dysfunction (ED, impotence; inability to get or keep an erection), and the symptoms of benign prostatic hyperplasia (BPH; an enlarged prostate) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency in adult men. Tadalafil (Adcirca) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Tadalafil is in a class of medications called phosphodiesterase (PDE) inhibitors.

It works to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Tadalafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow more easily.

If you are taking tadalafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Tadalafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

What is Cialis?

Cialis® is a drug that is used to treat erectile dysfunction (ED). It comes in four doses, 2.5 mg, 5 mg, 10 mg, and 20 mg. Cialis® can be taken as needed in any of the four doses. The 2.5 mg and 5 mg doses are also approved for daily use for ED. Cialis® in the 2.5 mg and 5 mg doses is also FDA-approved for men suffering from urinary symptoms due to benign prostatic hyperplasia (BPH) with or without ED. Physicians on the Roman platform do not currently treat BPH. If you feel you need Cialis for the treatment of BPH, please seek in-person care. For as needed dosing, the 10 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Cialis® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may lead the doctor or nurse practitioner to recommend one drug over the other based on your treatment goals.

What is tadalafil?

Tadalafil is the chemical name of the active ingredient in Cialis®. Cialis® was originally patented and sold by Eli Lilly. It is FDA-approved to treat ED and urinary symptoms due to BPH. After the patent expired in 2018, the FDA gave permission to other drug companies to manufacture a generic version of Cialis®. The FDA requires generic drugs to be bioequivalent to the brand name version. This means that they act the same way in the body and are expected to produce the same effects as the original brand name drug. Generic drugs are generally much cheaper than the original brand name drug, and most drugs prescribed in the US are generic.

Who makes generic Cialis?

A partnership between ICOS Corporation and Eli Lilly and Company (Lilly ICOS LLC) developed Cialis, which received approval from the Food and Drug Administration (FDA) in 2003.

Eli Lilly eventually bought ICOS and held an exclusive patent on the drug until it reached a settlement in 2018 with companies looking to offer a generic version of the popular ED medication.

Among the companies that produce generic Cialis with FDA approval are:

  • Accord Healthcare
  • Ajanta Pharma
  • Alembic Pharmaceuticals
  • Amneal Pharmaceuticals
  • Apotex Corp
  • AvKARE, Inc
  • AvPAK
  • Burel Pharmaceuticals
  • Camber Pharmaceuticals
  • Cipla
  • Dr. Reddy’s Laboratories
  • Lupin
  • Macleods Pharmaceuticals
  • Mylan
  • Nivagen Pharmaceuticals
  • Northstar Rx LLC
  • Prasco Laboratories
  • Sunshine Lake Pharma Co.
  • Teva Pharmaceutical Industries
  • Torrent Pharmaceuticals Limited
  • Unichem Pharmaceuticals
  • Zydus Pharmaceuticals

How Should Cialis be Used?

Tadalafil comes as a tablet to take by mouth. It may be taken with or without food.

If you are taking tadalafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. There are two different ways to take tadalafil, either daily or on an as needed basis. Talk to your doctor about which dosing schedule is right for you. Tadalafil is sometimes taken as needed, usually at least 30 minutes before sexual activity and not more often than once every 24 hours. Your doctor will help you decide the best time for you to take tadalafil before sexual activity. Tadalafil is also sometimes taken once a day every day without regard to timing of sexual activity. You may attempt sexual activity at any time between doses. If you are taking tadalafil on a regular schedule, take it at around the same time every day. If you have certain health conditions or are taking certain medications, your doctor may tell you to take tadalafil less often or may prescribe a lower dose to be taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tadalafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are taking tadalafil to treat PAH or BPH, follow your doctor’s directions and the guidelines in this paragraph. You should take tadalafil one time a day. Take all of the tablets for your daily dose at one time each day; do not divide the tablets to take as separate doses. Take tadalafil at around the same time every day. If you are already taking medication to treat BPH, your doctor may tell you to stop taking your other medication at least one day before starting treatment with tadalafil. Follow your doctor’s directions carefully, and ask your doctor or pharmacist to explain any part you do not understand.

If you are taking tadalafil for erectile dysfunction, your doctor will probably start you on an average dose of tadalafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if tadalafil is not working well or if you are experiencing side effects.

If you are taking tadalafil for PAH, you should know that tadalafil controls PAH but does not cure it. Continue to take tadalafil even if you feel well. Do not stop taking tadalafil without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Is Cialis Used to Treat Enlarged Prostate?

Yes, Cialis is FDA-approved to treat enlarged prostate (benign prostatic hyperplasia). This condition is common in men over the age of 50. However, if you are suffering from symptoms of enlarged prostate, such as a constant need to urinate, you should seek in-person treatment from a healthcare provider. Hims only offers access to online consultations for the treatment of erectile dysfunction.

Other uses for Cialis

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking tadalafil,

  • tell your doctor and pharmacist if you are allergic to tadalafil, any other medications, or any of the ingredients in tadalafil tablets. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking or have recently taken riociguat (Adempas) or nitrates such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates. Your doctor will probably tell you not to take tadalafil if you are taking nitrates.
  • tell your doctor if you are taking street drugs containing nitrates (‘poppers’) such as amyl nitrate, butyl nitrate, or nitrite while taking tadalafil. Your doctor will probably tell you not to take tadalafil if you are taking street drugs containing nitrates.
  • you should know that tadalafil is available under the brand names Adcirca and Cialis. You should only be treated with one of these products at a time.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), dutasteride (Avodart, in Jalyn), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax, in Jalyn), and terazosin; amiodarone (Cordarone, Pacerone); certain antifungals such as fluconazole (Diflucan), griseofulvin (Grifulvin, Gris-PEG), itraconazole (Onmel, Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegel), and voriconazole (Vfend); aprepitant (Emend); bosentan (Tracleer); carbamazepine (Carbatrol, Epitol, Tegretol, Teril, others); clarithromycin (Biaxin, in Prevpac); diltiazem (Cardizem, Cartia,Tiazac, others); efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra), lovastatin (Altocor, in Advicor); medications for high blood pressure; nefazodone; nevirapine (Viramune); other medications or treatments for erectile dysfunction; other medications or treatments for PAH; phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); sertraline (Zoloft); telithromycin (Ketek); and verapamil (Calan, Covera,Verelan, in Tarka). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what herbal products you are taking, especially St. John’s wort.
  • tell your doctor if you smoke; if you have ever had an erection that lasted more than 4 hours; and if you have recently had diarrhea, vomiting, not been drinking enough fluids, or sweating a lot which may have caused dehydration (loss of a large amount of body fluids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); any condition that affects the shape of the penis; diabetes; high cholesterol; high or low blood pressure; irregular heartbeat; a heart attack or heart failure; angina (chest pain); a stroke; ulcers in the stomach; a bleeding disorder; blood circulation problems; blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); or heart, kidney, or liver disease. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
  • if you are a woman and you are taking tadalafil to treat PAH, tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking tadalafil, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tadalafil.
  • talk to your doctor about the safe use of alcoholic beverages during your treatment with tadalafil. If you drink a large amount of alcohol (more than five glasses of wine or five shots of whiskey) while you are taking tadalafil you are more likely to experience certain side effects of tadalafil such as dizziness, headache, fast heartbeat, and low blood pressure.
  • if you are taking tadalafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately or get emergency medical treatment, and avoid sexual activity until your doctor tells you otherwise.
  • tell all your health care providers that you are taking tadalafil. If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took tadalafil.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

If you are taking tadalafil for erectile dysfunction on a regular schedule, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose or more than one dose per day to make up for a missed one.

If you are taking tadalafil for PAH or BPH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

how long does it take for Cialis to work?

Cialis doesn’t work right away. For the as-needed dose, plan to take Cialis at least 30 minutes before sexual activity, but bear in mind it may take as long as 2 hours to take effect.

Also, Cialis requires sexual stimulation to be effective, so arousal is an important part of the equation.

There are many considerations that affect how long it takes Cialis to take effect for ED. This includes factors such as:

  • other health conditions you may have
  • other medications you may take
  • your age
  • your diet
  • your dose of Cialis
When taken as-needed and at a higher dose, Cialis typically starts working within 30-60 minutes, so you will need to take it about an hour before sex to give it time to kick in.
However, when Cialis is taken daily and at a lower dose, it may take a few days to build up in your system. After four or five days of daily use, you may find that you are able to have successful sex at your leisure.

How does Cialis work?

Cialis is a phosphodiesterase type 5 (PDE5) inhibitor. It works for ED by relaxing smooth muscle in the blood vessels of the penis, therefore increasing blood flow.

PDE5 inhibitors only work in the presence of nitric oxide, which is naturally released during sexual arousal. PDE5 inhibitor medications work in 60 to 70 percent of people with ED.

Tadalafil is available in several doses in tablet form: 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg. Depending on the dose for ED, you can use it as needed before sexual activity, or take it once a day.

Let’s look at those two options, since dosing has a big effect on how it works.

How PDE5 inhibitors like Cialis work

Phosphodiesterase type 5 (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 are still necessary for the medications to help achieve and sustain an erection. When sexually aroused, the parasympathetic nervous system activates, triggering the release of a molecule called nitric oxide (NO). The increased presence of NO is what increases the production of cyclic GMP.

 How long does Cialis usually last?

Cialis can last from 24 to 36 hours. In some cases, it can last as long as 72 hours. This is one of the reasons Cialis has high patient satisfaction ratings in surveys compared to other PDE5 inhibitors: It allows more spontaneous sexual activity.

How long the medication lasts depends on:

  • the dose
  • what kind of dose (as needed versus daily)
  • your age
  • your liver and kidney function
  • other medications you may be taking
  • your health condition
  • your lifestyle and diet
The effects of Cialis can last up to 36 hours, but the highest amount of the drug can typically be found in the bloodstream between 30 minutes and six hours after taking Cialis. However, because Cialis remains in the body for longer than other ED medications, it is important not to take Cialis more than once every 24 hours.

How to take Cialis ?

Normally we can offers once-a-day Cialis in a 5mg dosage. Typically, this dosage of Cialis is taken once a day at the same time, no matter how often you have sex. Because Cialis stays in your system for 24-36 hours, spontaneous sex can happen when you want it . It only takes 4-5 days for daily Cialis to become fully effective and you can expect peak plasma concentration in as little as 30 minutes. Cialis can be taken with or without food, so taking it around the same meal time is an option. But, do not take Cialis more than once every 24 hours. As always, read all information that comes with your prescription, including all safety information, and only take Cialis as directed by your doctor.

What side effects can this medication cause?

Tadalafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • headache
  • indigestion or heartburn
  • nausea
  • diarrhea
  • flushing
  • pain in the stomach, back, muscles, arms, or legs
  • cough

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

  • sudden decrease or loss of vision (see below for more information)
  • blurred vision
  • changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
  • sudden decrease or loss of hearing (see below for more information)
  • ringing in ears
  • erection that lasts longer than 4 hours
  • dizziness
  • chest pain
  • hives
  • rash
  • difficulty breathing or swallowing
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • blistering or peeling of skin

Some patients experienced a sudden loss of some or all of their vision after they took tadalafil or other medications that are similar to tadalafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking tadalafil, call your doctor immediately or get emergency medical treatment. Do not take any more doses of tadalafil or similar medications such as sildenafil (Revatio, Viagra) or vardenafil (Levitra) until you talk to your doctor.

Some patients experienced a sudden decrease or loss of hearing after they took tadalafil or other medications that are similar to tadalafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking tadalafil, call your doctor immediately. Do not take any more doses of tadalafil or similar medications such as sildenafil (Revatio, Viagra) or vardenafil (Levitra) until you talk to your doctor.

Tadalafil may cause other side effects. Call your doctor if you have any unusual problems while taking this medication

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names

  • Adcirca®
  • Cialis®

Cialis vs. Viagra

Both Cialis (Tadalafil) and Viagra (Sildenafil) work to help you get it up and keep it up, but there are differences.

For starters, you always have to “time” your sex after taking Viagra — not so with daily Cialis. Cialis works for longer (up to 36 hours) compared with Viagra (2 to 4 hours).

Cialis comes in 4 doses (2.5mg, 5mg, 10mg and 20mg) and Viagra comes in 3 doses (25mg, 50mg or 100mg). Cialis can be taken on a full stomach unlike Viagra, which is not as effective on a full stomach (eg, delayed by 60 minutes with a high-fat meal).

And finally, cost: Cialis is less expensive per pill than Viagra but, taken as a daily regimen, it could cost more per month.

If cost is important to you, consider generic tadalafil at less than half the price.

What should I not take with Cialis?

High fat foods

Avoid high fat foods or heavy meals before taking Cialis and before sexual activity. High fat foods can affect how well Cialis works. It may also take longer to work.

Nitrates and other medications

Some medications can interact with Cialis and change its effectiveness. They include:

  • nitrates
  • antiseizure medications
  • HIV medications
  • certain antibiotics
  • oral antifungal medications
  • high blood pressure medications

Be sure to talk to your doctor or pharmacist about how to take all your medications to avoid interactions.

It’s important to avoid Cialis if you take chest pain (angina) and blood pressure medications in the nitrate category or alpha blocker drugs. They can lower your blood pressure to dangerous levels.

Alcoholic beverages

Use caution with alcohol consumption when taking Cialis. Too much alcohol can affect your ability to become aroused. It can also cause excessive low blood pressure, leading to headache, dizziness, and fainting.

Grapefruit and grapefruit juice

Avoid grapefruit with Cialis. It can increase the levels of the medication in the blood, causing increased side effects.

What else is important to know about taking Cialis?

Age

In some people over 65 years old, Cialis may last longer because it takes more time for your body to process the medication. This affects how soon it leaves your body.

Poor kidney function can increase Cialis levels in your body, increasing side effects. Your doctor may adjust your dose in this case.

Heart and other conditions

If you’re over 65, have a heart condition, or liver- or kidney-related problems, your doctor may need to adjust your dose of Cialis and monitor how the medication works for you.

Fake Cialis

Avoid buying Cialis without a doctor’s prescription. PDE5 medications are some of the most commonTrusted Source counterfeit medications sold online. They can cause serious health risks.

Take as prescribed

Take Cialis exactly as prescribed by your doctor. Don’t take extra doses or change your dosing schedule without talking with your doctor to avoid side effects.

The takeaway

ED is a common condition and can have many causes, including psychological and physiological reasons.

Risks of ED are higher with certain health conditions, so it’s important to openly talk with your doctor about your concerns. They can help you find the best treatment specific to your situation. This may include the need for ED medications.

Cialis is one of the most popular medications available for ED because it provides two types of dosing and lasts longer than other PDE5 inhibitor medications in this class, like sildenafil (Viagra).

There are several PDE5 inhibitor medications available, so discuss your needs and preferences with your doctor to select the medication best suited to you.

Remember, there are many causes for ED and many treatment options, including Cialis. Don’t be discouraged if Cialis doesn’t work the first time you try it. Your doctor can help adjust the dose or help you find other options to consider.

Drug interactions

Tell your healthcare provider if you take any of the following because these drugs interact with Cialis® and generic Cialis®:

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® or generic VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • Other medicines or treatments for ED
  • Adcirca® (tadalafil) is used to treat a rare disease called pulmonary arterial hypertension (PAH) and has the same active ingredient as Cialis®. Cialis® and generic Cialis® should not be used with Adcirca® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Revatio® [sildenafil citrate])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Cialis interactions

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, as 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, though heavy alcohol consumption can make it difficult to achieve an erection even with the use of an ED medication.

Know your other medications

Cialis may interact with certain medications. In particular, you should not take Cialis if you are 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 one day, as this can lead to a dangerous drop in blood pressure and other serious side effects.