Cialis® can be used both as a daily treatment or as needed before sex. This treatment plan is focused on daily Cialis® — how it works and how to effectively and safely use it to enhance erection strength and quality. You will also receive a physical document called a drug monograph or patient drug information in the package with your medication when it arrives from the pharmacy which contains full information about Cialis® — you should read all of the information that comes with your prescription shipment before taking your medication.
How Cialis® works
Cialis® belongs to a class of medications called phosphodiesterase 5 inhibitors. These medications boost sexual performance by increasing blood flow to the penis. They work by blocking the enzyme that turns off an erection (phosphodiesterase-5).
The effect of Cialis® on sexual performance depends directly on your blood level of Cialis® during sexual activity. It takes up to 5 days for your Cialis® blood level to reach steady state when you take it every day. Missing doses or taking Cialis® at inconsistent times can set you back significantly.
Consider a practice run
Trying your first one or two sexual experiences on daily Cialis® in a less pressured, more relaxed environment (i.e. during masturbation) can help you to understand how the medication affects your body and whether or not any treatment adjustments might be helpful before primetime.
Give Cialis® a few chances
It can take some time for your body to acclimate to Cialis®, so don’t rush to conclusions about whether or not it works. Things like alcohol consumption, fatigue, anxiety, and arousal can also affect sexual performance on any given day, even when you take medication to enhance sexual function.
Get in the mood
Cialis® works by enhancing and strengthening your body’s response to sexual stimulation and arousal. Some kind of mental or physical trigger is still required to kick off your body’s sexual response.
Tell your healthcare providers
Tell all your healthcare providers that you take Cialis®. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took Cialis®.
Alcohol
It is OK to drink alcohol when taking Cialis®, but not too much. Drinking more than 2-3 glasses of wine, beers, or shots of hard alcohol can increase your chances of headache, dizziness, fast heart rate, and low BP. Alcohol can also inhibit your erection.
Side Effects
Most common
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®. Back pain and muscle aches usually go away within 2 days of stopping daily Cialis®.
Rare but serious side effects
An erection that won’t go away (priapism)
If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
Sudden vision loss
Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Cialis® and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
Sudden hearing decrease or loss
Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Cialis® and contact a provider right away.
Other reported serious side effects
It is not known if Cialis® caused these problems, but other serious medical events that have been reported after Cialis® use include: heart attack, stroke, irregular heartbeats, seizures and death.
Where to find more side effects information
For more information, read the written drug information that comes with your medication, ask your healthcare provider, or ask your pharmacist.
Warnings
Do not take Cialis® more than 1 time a day
Do not take more than your prescribed dose of Cialis®
Who should not take Cialis®
Anyone taking medicines called nitrates (such as nitroglycerin)
Anyone using street drugs called "poppers" such as amyl nitrate or butyl nitrate
Anyone taking medicines called guanylate cyclase stimulators such as riociguat (Adempas)
Anyone allergic to tadalafil or any of the ingredients in tadalafil tablets
When to stop sexual activity
Stop sexual activity and seek medical help right away if you experience chest pain, dizziness, or nausea during sex after taking Cialis®. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
Stop taking Cialis® until you connect with us or a healthcare provider if any of the following conditions or events develop during treatment:
Heart problems such as angina, heart failure, irregular heartbeats, or heart attack.
Pulmonary hypertension
Very low or very high blood pressure
Stroke
Liver problems
Kidney problems or require dialysis
Retinitis pigmentosa, a rare genetic (runs in families) eye disease
Vision loss
Stomach ulcers
Bleeding problems
Deformed penis shape or Peyronie’s disease
Erection lasting more than 4 hours
Blood problems such as sickle cell anemia, multiple myeloma, or leukemia
Stop taking Cialis® until you connect with us or a healthcare provider if you start any of the following medications during treatment:
Medicines called nitrates like nitroglycerin or isosorbide
Medicines called guanylate cyclase stimulators such as riociguat (Adempas)
Medicines called alpha blockers such as Hytrin (terazosin), Flomax (tamsulosin), Cardura (doxazosin), Minipress (prazosin), Uroxatral (alfuzosin), Jalyn (dutasteride and tamsulosin), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of sildenafil 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)
Some types of oral antifungal medicines, such as ketoconazole (Nizoral), and itraconazole (Sporanox)
Some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
