Cialis (Tadalafil): How It Works, Where to Buy It, Effectiveness, and Safety

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Cialis is the brand name for tadalafil, a medication used to treat ED. It belongs to group of drugs called phosphodiesterase-5 (PDE5) inhibitors.

Cialis and generic Cialis (tadalafil) are taken as an oral tablet, either as a low dose daily medication or as a higher dose, “on-demand” medication.

Both the branded and generic tablets have the same primary ingredient, though the overall chemical make-ups are a little different. Still, both are equally effective. The main difference is the price.

Cialis works by increasing blood flow to the penis to help a person get and maintain an erection.

To do this, it blocks the PDE5 enzyme, which enhances the effects of nitric oxide (NO). Nitric oxide 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.

However, Cialis does not increase libido. Physical and psychological arousal is still necessary for the medication to help achieve and sustain an erection.

It also does not protect against sexually transmitted infections (STIs).

Cialis can be used to treat:

• ED: Cialis is primarily used to treat ED. Both the American Urological Association and the European Association of Urology Guidelines recommend considering a PDE5 inhibitor as the first-line treatment for ED as long as it doesn’t interfere with your other medications or cause you to have any severe side effects.
• Benign prostatic hyperplasia (BPH): Cialis and tadalafil are also prescribed to treat the symptoms of BPH, also known as an enlarged prostate.
• Pulmonary arterial hypertension (PAH): Tadalafil is also FDA approved to treat pulmonary arterial hypertension, which is high blood pressure affecting the arteries in the lungs. The typical dose for PAH is two 20-milligram (mg) tablets (40 mg) taken daily. Adcirca is the brand name for tadalafil, which 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. You have a couple of different options for when to take the pill:

• Daily: You can take a daily, low dose pill in a 2.5- or 5-mg tablet. Doctors usually start their patients on the 2.5-mg dose. The 5-mg dose may be appropriate if needed for greater effectiveness, though it may lead to undesirable side effects for some people.
• On-demand: If you prefer, you can take a stronger dose as needed before sexual activity. In this case, 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 2016 study showed that while low dose daily use may have produced a slightly weaker effect than the higher-dose, on-demand use in some study participants, there did not appear to be a major benefit with one approach over the other.

To get the most out of Cialis:

• Time your dose appropriately: With an on-demand dose, take Cialis at least 30 minutes prior to sexual activity. Just understand that it could take up to 2 hours to take effect. With a daily dose, take it at about the same time every day.
• Focus on managing stress: Stress can be a contributing factor to ED. It can also affect how well Cialis works.
• Focus on overall wellness: Eating a nutritious diet, being physically active, abstaining from smoking, and moderating alcohol consumption can all make a difference.

In clinical trials, some of the most common side effects associated with Cialis were:

• 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 different research published in 2016.

In clinical trials, muscle aches usually went away within about 48 hours.

But many people who take Cialis or generic tadalafil do not experience side effects. Those who do often have minor effects that tend to go away once the drug is out of their system.

More potential and serious symptoms include priapism, an abnormal, sometimes painful erection that lasts more than 4 hours.

If you have any sudden changes in vision or hearing, which occasionally occur with tinnitus and dizziness, reach out to a healthcare professional immediately.

The price of brand-name Cialis will vary based on:

• the dosage
• the pharmacy or online service you choose
• any shipping and handling charges that may be included

In general, a lower dose (2.5 mg and 5 mg) that’s meant for daily use can cost around $15 to $17 per dose, and a higher dose (10 mg and 20 mg) meant for “as-needed” use can cost around $60 per dose. But discounts may be available when buying in bulk or through any website promotional offers.

It’s also worth considering generic Cialis (tadalafil) if brand-name Cialis is outside of your budget. Tadalafil has the same active ingredients as Cialis but is sold at a significantly lower price.

If you do not want to or cannot visit your doctor in person, you may be able to get a prescription for Cialis online. There are a few telehealth services that offer easy and discreet options.

In addition to Cialis, there are several different medications that can treat ED symptoms. Examples include tadalafil (the generic version of Cialis) and Viagra. So if you’re wondering which one might be best choice for your needs, here’s a closer look at how these medications compare.

Is generic Cialis or tadalafil as effective as Cialis?

Cialis and 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 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 $300 to $1,735 for 30 tablets. The generic versions cost about $12 to $25 for 30 tablets.

Is Cialis stronger than Viagra?

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 up to 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, research from 2021 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.

Unlike some other PDE5 inhibitors, Cialis may be taken with or without food. Food is unlikely to have any effect on its effectiveness or side effects.

Still, there are a few other things to keep in mind when taking the medication.

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 get an erection — even with an ED medication.

Discuss your other medications with your doctor

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, the brand-name 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 do not “cure” the condition, they can treat the primary symptom by helping you get and maintain erections.

Cialis is available by prescription only, so talk with a doctor about this and other possible ED treatments.