- Tadalafil (Cialis) is available in generic and brand versions in several doses as an oral tablet.
- You can take Cialis as needed or once a day, depending on the dose and how it’s prescribed.
- Cialis takes from 30 minutes to 2 hours to take effect. It can last up to 36 hours.
- Cialis is a PDE5 inhibitor medication approved for use for erectile dysfunction (ED) and benign prostatic hyperplasia.
- Don’t take Cialis with nitrate class medications. Doing so can cause a dangerous drop in blood pressure.
- If an erection lasts more than 4 hours, seek immediate medical attention.
Cialis is a brand of tadalafil, one of the most popular medications to treat erectile dysfunction (ED). It was first approved in 2003.
Cialis is popular because it offers dosing flexibility, works well, and is convenient to take.
Let’s take a quick look at how Cialis works, then get into how long it takes to act, how long it lasts, and things you can do that affect results.
Taking the medication properly will help you get the maximum effect.
How common is ED?
ED is a common condition. It affects between
While there are many causes of ED,
- high blood pressure
- diabetes
- physical inactivity
- heart disease
- high cholesterol
- smoking
Certain surgeries, such as prostate gland removal (radical prostatectomy) or surgeries in the lower pelvic or rectal area, may also cause ED.
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
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.
Cialis offers two dosing options, which increase flexibility and allows greater choice. Your health, lifestyle, and the dosing of Cialis can affect how well the medication works.
A 2017 review of 16 studies comparing sildenafil (Viagra) and tadalafil found they’re equally effective for ED and have similar safety profiles.
But the review found tadalafil is preferred over sildenafil by users and their partners, and increases confidence.
Two important benefits of Cialis include dosing flexibility and long half-life. Tadalafil is the longest lasting PDE5 inhibitor medication for ED.
As-needed dosing
The usual starting dose for as-needed Cialis is 10 mg. It’s adjusted upward or downward depending on how you react to the medication.
Don’t take more than one dose per day to avoid the risk of a prolonged, painful erection (priapism), drop in blood pressure, or other serious side effects.
Take one tablet 30 minutes before sexual activity as directed by your doctor.
Daily dosing
The usual starting dose for once-daily Cialis is 2.5 mg. Your doctor might increase the dose to 5 mg based on how you react to the medication.
Take one tablet as prescribed at the same time each day. Many people who take Cialis prefer this dosing because it provides flexibility for timing of sexual activity.
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
Tip for useTake the daily dose at the same time every day to ensure there’s a steady level of the medication in your system.
Since you don’t need to plan ahead for sexual activity, many men and their partners prefer this dosing regimen.
Cialis
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
Take as directed
For as-needed dosing, take Cialis at least 30 minutes or more before sexual activity.
If your prescription involves taking Cialis daily, take it at the same time each day. This maintains steady levels of Cialis in your body.
Take as part of a lifestyle with physical activity
Smoking, heavy drinking, unmanaged stress, and an unhealthy diet can affect ED as well as how Cialis works, potentially leading to more side effects.
A healthy diet, increasing physical activity, and quitting smoking are important for wellness, physical health, and can affect the severity of ED.
Strategies to reduce stress and support your relationship with your partner can also improve sexual performance and well-being.
Communicate and stay relaxed
Working with a psychiatrist, therapist, or sex therapist can help you navigate strategies for the mental and emotional side of intimacy.
Other ways to improve your sexual performance include managing stress, working through relationship concerns, and treating performance anxiety.
If you’re anxious, stressed, depressed, or nervous, Cialis may not work as well. It’s important to relax and be aroused for the medication to work best.
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.
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
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.
Common side effects
The most common side effects of Cialis include:
- back pain
- diarrhea
- flushing (redness of the face, neck, or chest)
- headache
- upset stomach
- muscle aches
Serious side effects
Serious side effects of Cialis include:
- priapism, a painful erection lasting longer than 4 hours, which can cause tissue damage
- low blood pressure
- changes in hearing and vision
When to get medical helpFor more information on drug interactions or side effects of Cialis, talk to your doctor or pharmacist.
If you experience serious side effects, call 911 or your local emergency services.
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.
FAQs
When is the best time to take Cialis for maximum effect? ›
You should take Cialis at least 2 hours before you plan to have sex. The effects may last for up to 36 hours after you take it.
Is 20mg of Cialis a day too much? ›The maximum recommended dosage of Cialis is 20 mg once per day. Taking a dose of Cialis that's higher than recommended could increase your risk for side effects. These can include serious side effects such as drops in blood pressure or priapism (a painful erection that won't go away).
Can I take 40mg of Cialis? ›Is 40 mg of Cialis safe? Taking 40 mg of Cialis could be dangerous and raise the risk of side effects such as a sudden drop in blood pressure and priapism. The typical dose is 10 mg for occasional use and 2.5 or 5 mg for daily use. The typical maximum dose of Cialis for ED is 20 mg once a day.
How long will I stay hard with Cialis? ›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): As needed: dose taken as directed, at least 30 minutes before sexual activity.
What part of the day is it best to take Cialis? ›Cialis Daily must be taken once every 24 hours, with or without food. It's best to get into a routine and take it at the same time each day, as you should never take more than one tablet in a 24-hour period. Cialis should be taken 30-60 minutes before you plan to have sex.
Why is my 10 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.
What happens if Cialis doesn't work? ›If you're prescribed a lower dosage of Cialis and you find that it's not fully effective (for example, you notice some improvements but still have difficulty maintaining an erection), it's a good idea to discuss this with your healthcare provider to see if switching you to a higher dose is appropriate.
How many erections per day? ›People with penises have an average of 11 erections per day and three to five more each night, but everyone is different. There are numerous factors that can affect how often you get hard, like your age, hormone levels, and lifestyle.
Can you take 2 Cialis pills at once? ›If your doctor recommends that you take Cialis only as needed for ED, the usual dosage is 10 mg before sexual activity. They may reduce this to 5 mg if the medication is working too well. But if this dose doesn't work for you, your doctor may have you take two 5 mg tablets of Cialis at once.
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.
What happens if you take too much Cialis? ›
Cialis® also contains tadalafil. If you take too much tadalafil or take it together with these medicines, the chance for side effects will be higher. If you experience a prolonged erection for more than 4 hours or a painful erection for more than 6 hours, contact your doctor immediately.
Does alcohol affect Cialis? ›Having just a glass of wine or other drink is unlikely to affect Cialis or cause any health risks. But if you take Cialis and drink excessively, you may be setting yourself up for some problems. In particular, drinking too much alcohol while you take Cialis can lead to orthostatic hypotension.
Does Cialis work better if taken daily? ›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.
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).
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.
How long does 20mg Cialis last? ›As a treatment for erectile dysfunction, the 20mg dosage of Cialis offers several advantages compared to Viagra: It's longer-lasting. The effects of Cialis 20mg last for approximately 36 hours, making it a very long-lasting treatment for erectile dysfunction.
When is the best time to take Cialis 20mg? ›You may take a CIALIS tablet at least 30 minutes before sexual activity. CIALIS may still be effective up to 36 hours after taking the tablet. Do not take CIALIS more than once a day. CIALIS 10 mg and 20 mg is intended for use prior to anticipated sexual activity and is not recommended for continuous daily use.
Why is my Cialis 5mg daily 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.
Why is my Cialis no longer working? ›If you're prescribed a lower dosage of Cialis and you find that it's not fully effective (for example, you notice some improvements but still have difficulty maintaining an erection), it's a good idea to discuss this with your healthcare provider to see if switching you to a higher dose is appropriate.