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Generic name: tadalafil [ ta-DAL-a-fil ]
Other brand names of tadalafil include: Adcirca, Cialis
Drug class: Impotence medications

What is Cialis?

Cialis relaxes muscles of the blood vessels and increases blood flow to particular areas of the body.

Cialis is used to treat erectile dysfunction (impotence) and symptoms of benign prostatic hypertrophy (enlarged prostate).

Another brand of tadalafil is Adcirca, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Do not take Cialis while also taking Adcirca, unless your doctor tells you to.

Warnings

Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as “poppers”. Taking tadalafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

Some medicines can cause unwanted or dangerous effects when used with Cialis. Tell your doctor about all your current medicines, especially riociguat (Adempas).

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Get medical help at once if you have nausea, chest pain, or dizziness during sex.

Stop using Cialis and get emergency medical help if you have sudden vision loss.

Before taking this medicine

You should not take Cialis if you are allergic to tadalafil.

Taking Cialis with certain other medicines can cause a sudden and serious decrease in blood pressure. Do not take this medicine if you also use:

riociguat (to treat pulmonary arterial hypertension); or
a nitrate drug (for chest pain or heart problems) such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, or recreational drugs such as amyl nitrate or nitrite “poppers”.

Some tadalafil can remain in your bloodstream for 2 or more days after each dose you take (longer if you have liver or kidney disease). Avoid nitrate use during this time. Buy Cialis in USA Online

To make sure this Cialis is safe for you, tell your doctor if you have ever had:

heart disease or heart rhythm problems;
a heart attack or stroke;
angina (chest pain), high or low blood pressure;
pulmonary hypertension (unless you are taking tadalafil for this);
a condition called pulmonary veno-occlusive disease (narrowing of the veins that carry blood from the lungs to the heart);
liver or kidney disease (or if you are on dialysis);
vision loss, or retinitis pigmentosa (an inherited condition of the eye);
a bleeding disorder;
a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
a physical deformity of the penis (such as Peyronie’s disease), or an erection lasting longer than 4 hours;
a stomach ulcer; or
health problems that make sexual activity unsafe.

Sudden vision loss has occurred in a small number of people taking medicines like tadalafil (Viagra or others). Most of these people already had certain eye problems or had high cholesterol, diabetes, coronary artery disease, a history of smoking, or were over 50 years old). It is not clear whether the medicine was the actual cause of vision loss. Cialis for sale in UK Online

Cialis is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether tadalafil passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Cialis is not approved for use by anyone younger than 18 years old.

How should I take Cialis?

Cialis is usually taken only once per day. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Cialis for sale in Canada

Cialis can be taken with or without food.

Do not break or split a tablet. Swallow it whole.

For erectile dysfunction, take Cialis just before sexual activity but not more than once per day.

Cialis can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor’s instructions.

Do not take Cialis for erectile dysfunction if you are taking Adcirca for pulmonary arterial hypertension.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

As Cialis is used as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Drinking alcohol with this medicine can cause side effects.

Grapefruit and grapefruit juice may interact with tadalafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking this medicine. Buy Cialis i England Online

Cialis side effects

Get emergency medical help if you have signs of an allergic reaction to Cialis: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop and get medical help at once if you have nausea, chest pain, or dizziness during sex. You could be having a life-threatening side effect.

Stop using this medicine and call your doctor at once if you have:

a light-headed feeling, like you might pass out;
an erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis);
vision changes or sudden vision loss;
ringing in your ears or sudden hearing loss; or
heart attack symptoms – chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.

Common Cialis side effects may include:

headache;
flushing (warmth, redness, or tingly feeling);
nausea, upset stomach;
stuffy nose; or
muscle pain, back pain, pain in your arms, legs, or back.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Cialis?

Tell your doctor about all your current medicines and any you start or stop using, especially:

medicines to treat erectile dysfunction or pulmonary arterial hypertension;
an antibiotic or antifungal medicine;
antiviral medicine to treat hepatitis C or HIV/AIDS;
drugs to treat high blood pressure or a prostate disorder; or
seizure medicine.

This list is not complete. Other drugs may interact with tadalafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Popular FAQ

Can you take Cialis and Viagra together? Risks explained.

Cialis (tadalafil) and Viagra (sildenafil) are both prescription drugs used to treat erectile dysfunction (ED), but taking them together is generally not recommended. Mixing these medications can lead to dangerously low blood pressure and a higher risk of side effects. Buy tadalafil in USA Online

Why People Consider Taking Both

Some men wonder if using both Cialis and Viagra might improve results. Perhaps one drug isn’t working well enough, or they’re looking for faster or longer-lasting effects. Both drugs are PDE5 inhibitors, which means they work in similar ways by relaxing blood vessels to improve blood flow to the penis. Some studies have evaluated using daily Cialis with as-needed Viagra in certain patients, but this should only be done under strict medical supervision. Tadalafil for sale In Canada Online

Why Combining Cialis and Viagra Is Unsafe

Using Cialis and Viagra together puts extra strain on your cardiovascular system. Since both medicines expand blood vessels, combining them can cause a significant drop in blood pressure. This can lead to dangerous symptoms, including dizziness, fainting, rapid heartbeat (palpitations), chest pain, or even a serious condition called priapism—an erection lasting longer than four hours. Always let your healthcare provider know about any ED medications you use so they can keep you safe.

When Doctors Might Adjust ED Treatment

If a single ED medication isn’t working, doctors may consider switching you from as-needed Viagra to a daily low dose of Cialis or vice versa, but most won’t recommend taking both at once. There is no approved medical protocol for using Cialis and Viagra together, and combining them does not follow FDA or clinical guidelines. Buy Viagra in USA,UK & Canada Online

Safer Alternatives

If combining Cialis and Viagra isn’t safe, there are still effective ways to manage erectile dysfunction. Doctors often recommend adjusting your treatment plan to find the best solution for your needs, rather than mixing medications. Here are some safer alternatives to consider:

Your doctor may suggest adjusting the dosage or timing of your ED medication; for instance, taking Cialis daily instead of using Viagra only as needed.
Addressing lifestyle factors, such as improving diet, exercise, and reducing stress, can sometimes help with ED.
Psychological support or counseling is recommended if emotional factors contribute to erectile issues.
Switching to a different PDE5 inhibitor or trying newer therapies may be explored if current treatment is ineffective.

What to Do If You Accidentally Take Both

If you accidentally take Cialis and Viagra together and experience symptoms like chest pain, severe dizziness, or an erection lasting more than four hours, seek emergency help immediately. Otherwise, contact your doctor or the local poison control center for advice (1-800-222-1222).

Key Takeaways

Combining Cialis and Viagra is not safe and isn’t proven to be more effective than using a single ED medication in large clinical studies.
Risks include dangerously low blood pressure, heart problems, and priapism.
Safer options include switching drugs or adjusting the dose.
Contact a doctor right away if you accidentally mix these medications and have concerning symptoms.

This is not all the information you need to know about Cialis and Viagra for safe and effective use and does not take the place of your doctor’s directions. Review the full product instructions and discuss this information and any questions you have with your doctor or other health care provider

Does Cialis lower blood pressure?

When used alone, Cialis (tadalafil) may cause small reductions in blood pressure, but if used with nitrates or guanylate cyclase stimulators like riociguat (brand name: Adempas) your blood pressure may dangerously drop. Do not use these drugs with Cialis. You could get dizzy, faint, or have a heart attack or stroke.

Other drugs or substances that may lower blood pressure when combined with Cialis include alpha blockers, other medicines to treat high blood pressure (hypertension) and use of alcohol.

Cialis is an oral prescription medicine approved for the treatment of:

erectile dysfunction (ED)
symptoms of benign prostatic hyperplasia (BPH)
both ED and BPH

If you develop chest pain, contact your healthcare provider, go to the nearest emergency room, or call 911 right away. Tell all of your healthcare providers that you take Cialis (tadalafil).

Avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position. In general, your blood pressure should be stable and you should be on a steady dose of one medication before you start the other.

Tell your doctor and pharmacist about all prescription, over-the-counter, herbal, vitamin or recreational drugs you use before starting treatment with Cialis. Other combinations may be unsafe.

Here’s more details:

Blood pressure may drop to dangerous levels if Cialis is combined with nitrates. Nitrates are a class of drug which includes medicines like nitroglycerin, isosorbide mononitrate, isosorbide dinitrate or Bidil (isosorbide dinitrate and hydralazine hydrochloride) used for chest pain (angina) or heart failure. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.

Nitrates can also include recreational drugs called “poppers” (amyl nitrite and butyl nitrite).

A serious drop in blood pressure can also occur if Cialis is used with a guanylate cyclase stimulator medicine (for example: riociguat [brand name: Adempas], used to treat high blood pressure in the lungs. Do not use nitrates or riociguat if you are also taking Cialis. Ask your doctor or pharmacist if you are not sure if you take any of these medicines.

Cialis may also lead to low blood pressure if used with some alpha-blockers, antihypertensives (blood pressure-lowering medicines) or substantial amounts of alcohol (for example, 5 glasses of wine or 5 shots of whiskey).

Cialis may cause small reductions in blood pressure (7 to 10 mm Hg) when it’s used alone or combined with certain medicines to lower blood pressure (antihypertensives).

Do not use Cialis with other PDE5 inhibitors for erectile dysfunction like Viagra (sildenafil), Stendra (avanafil) or vardenafil.

Low blood pressure with these medicines may occur if you are taking Cialis either as needed for erectile dysfunction (ED) OR once a day for Benign Prostatic Hyperplasia (BPH) and / or ED.

Ask your healthcare provider if it is safe for you to have sexual activity. You should not take Cialis if your healthcare provider has told you not to have sexual activity because of any health problems

Which drugs can cause low blood pressure with Cialis?

Nitrates

Nitrates like nitroglycerin are commonly used to treat angina, a symptom of heart disease. Angina symptoms include pain in your chest, jaw, or down your arm. Nitrates are commonly found in medicines that come as tablets, sprays, ointments, pastes, or patches. Do not use Cialis with any nitrate. If you are not sure if a drug is a nitrate, ask your health care provider.

Common brand names of nitroglycerin include:

Nitro-Dur
Nitrolingual Pump Spray
NitroMist
Nitrostat
Rectiv

Nitrates can also be found in other medicines such as isosorbide dinitrate (Isordil) or isosorbide mononitrate.

Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrite and butyl nitrite.

If you have taken Cialis, but your doctor decides a nitrate is medically necessary, you must wait at least 48 hours since your last dose of Cialis before nitrate administration can be given by your healthcare provider. Your doctor should monitor your blood pressure under close medical supervision when you receive the nitrate.

Guanylate cyclase stimulators

Do not take Cialis with Adempas or if you take any medicines from a class of drugs called called guanylate cyclase stimulators.

Guanylate cyclase stimulators include a medicine called Adempas (generic name: riociguat), used to treat conditions that cause high blood pressure in the lungs (pulmonary arterial hypertension and chronic-thromboembolic pulmonary hypertension). Do not use Cialis with any guanylate cyclase stimulator.

Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are guanylate cyclase stimulators, such as riociguat.

Vasodilators: Alpha Blockers

If Cialis is taken with certain alpha blockers, your blood pressure could suddenly drop, and you could get dizzy or faint. Alpha blockers can dilate (widen) your blood vessels which may cause low blood pressure. When they are used together, they may cause an additive effect on blood pressure and you may experience very low blood pressure, dizziness or fainting.

Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure and include medicines like Hytrin (terazosin), Flomax (tamsulosin), Cardura (doxazosin mesylate), Minipress (prazosin), Uroxatral (alfuzosin), Jalyn (dutasteride and tamsulosin) or Rapaflo (silodosin).

BPH

Cialis is not recommended for use in combination with alpha-blockers for the treatment of BPH due to the risk of blood pressure lowering.

Patients taking an alpha-blocker therapy for BPH should discontinue their alpha-blocker at least one day prior to starting Cialis for once daily use for the treatment of BPH, under direction from their doctor.

ED

Caution is advised when PDE5 inhibitors are coad ministered with alpha-blockers. Patients with ED should be stable on alpha-blocker therapy before starting Cialis, and the lowest recommended dose should be used to start treatment.

If you experience any dizziness, low blood pressure, or fainting while taking these medicines, contact your doctor right away.

Tell your doctor if you take any medicines to lower your blood pressure or to treat BPH or ED, or if you currently use any other PDE5 inhibitor, like Viagra (sildenafil), Stendra (avanafil) or vardenafil; or if you use a drug to treat pulmonary hypertension called Adcirca or Revatio.

Alcohol

You should also avoid drinking too much alcohol when taking Cialis (for example, 5 glasses of wine or 5 shots of whiskey). Drinking excessive alcohol can increase your risk of getting a headache, a fast heart rate, low blood pressure( especially when standing up), dizziness, or fainting.

Alcohol is also a mild vasodilator and can cause low blood pressure.

The amount of alcohol that might cause these side effects could vary between people, so use caution if you combine Cialis with any alcoholic beverages. Ask your doctor if it is safe for you to drink alcohol while taking Cialis.

Antihypertensives (blood pressure medicines)

Using Cialis with blood pressure medicines like amlodipine, angiotensin II receptor blockers (ARBs), bendrofluazide, enalapril, and metoprolol may cause small reductions in your blood pressure, based on studies done by the manufacturer.

For example, one study looked at the interaction of angiotensin II receptor blockers (ARBs), used alone or with other blood pressure medicines, and Cialis 20 mg.

Angiotensin II receptor blockers include agents like Benicar (olmesartan), Diovan (valsartan), and Cozaar (losartan).
After dosing, blood pressure measurements revealed differences between Cialis and placebo (inactive pill) of 8 / 4 mm Hg in systolic / diastolic blood pressure.

Another study looked at the interaction between 5 mg of amlodipine (Norvasc), a calcium channel blocker, and Cialis 10 mg.

After Cialis dosing, blood pressure measurements when lying down were reduced by 3 / 2 mm Hg for systolic / diastolic blood pressure when compared to placebo.
However, a similarly conducted study using Cialis 20 mg did not find significant differences in blood pressure.

Small reductions in blood pressure were also seen when studies looked at enalapril, metoprolol and bendrofluazide.

The clinical significance of these blood pressure reductions can vary between people based on many factors. Ask your doctor if it safe for you to take your blood pressure or heart medicine with Cialis.

Does Cialis lower blood pressure if used alone?

Low blood pressure is not listed as a common side effect with Cialis when used alone.

When used alone, Cialis can dilate blood vessels which may cause small, temporary decreases in blood pressure, but in general this should not be a problem for most healthy people. Modest decreases of up to a 7 mm reduction in systolic and 5 mm in diastolic lasting up to 12 hours may occur.

Tell your doctor if you have low blood pressure or high blood pressure that is not controlled before you start treatment with Cialis.
Also tell them about any heart problems you might have, such as angina (chest pain), heart failure, irregular heartbeats, pulmonary (lung) hypertension, or a previous heart attack.

Tell your healthcare provider and pharmacist about all the medications you take. Use with other medicines may cause dangerous drops in blood pressure.

Does Cialis raise blood pressure?

High blood pressure (hypertension) has been noted as a possible, but infrequent, side effect in a 24-week long study. It is not a common side effect with Cialis and was not seen in all studies.

In general, hypertension is considered a blood pressure reading of 130 / 80 millimeters of mercury (mm Hg) or higher.

In the study, participants received either Cialis 2.5 mg, Cialis 5 mg or a placebo (inactive treatment), given once daily for erectile dysfunction (ED).

Hypertension (high blood pressure) was reported in:

3% of people taking the 5 mg dose
1% of people taking the 2.5 mg dose
0% of people taking a placebo

Before you start treatment with Cialis, tell your doctor if you have high blood pressure that is not controlled. Cialis is not recommended for use if you have uncontrolled blood pressure, a recent heart attack or stroke, chest pain (angina), heart failure, irregular heart beats, severe liver disease or retinal eye problems (for example: macular degeneration or diabetic retinopathy).

What side effects should I expect to see with Cialis?

The most common side effects with Cialis, which are usually temporary, include:

Headache
Indigestion
Back pain
Muscle pain
Stuffy or runny nose
Flushing (facial redness)
Pain in the arms or legs

Back pain or muscle aches, if they occur, usually occur 12 to 24 hours after a dose of Cialis and typically go away within 2 days.

Common cold symptoms, gastroenteritis (stomach infection), and upper respiratory tract infections have also been reported.

Rarely a prolonged and painful erection of the penis lasting four hours or more (call priapism) may occur. If this occurs, or you have any other side effects that concern you, seek urgent medical help or call 911 right away.

Call your healthcare provider if you get any side effect that bothers you or one that does not go away.

This is not all the information you need to know about Cialis (tadalafil) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

Cialis vs Viagra – What’s the difference between them?

Which is better viagra or cialis?

Cialis and Viagra are both PDE5 inhibitors used for the treatment of erectile dysfunction (ED).

Both only work when a man is sexually aroused.
Cialis lasts for around 36 hours compared with only 4 to 5 hours for Viagra.
Food does not affect the activity of Cialis, whereas food may decrease the effectiveness of Viagra.
Cialis can be used once daily, at a smaller dosage, and is also effective at treating benign prostatic hyperplasia (BPH).
Dosage of Cialis may need to be reduced in men with liver or kidney problems and risk of interactions may be higher than with Viagra.

What ingredients are contained in Cialis or Viagra and how do they work?

Cialis is the brand name for tadalafil and Viagra is the brand name for sildenafil.^1,2 Both belong to a class of medicines known as phosphodiesterase type 5 (PDE5) inhibitors. PDE5 inhibitors work only in the presence of sexual stimulation, as they rely on the natural release of nitric oxide (NO), a chemical only released during sexual arousal. NO in turn activates other substances to relax the smooth muscle inside the penis to allow the inflow of blood and an erection to occur.^1,2,3 PDE5 inhibitors enhance the effect of NO.^1,2

Which drug was approved first?

On March 27 ^th, 1998, Viagra became the first oral pill, and the first PDE5 inhibitor, to be approved by the FDA to treat ED.⁴ A generic for Viagra was approved in March 2016 ⁵ and released in December 2017.

Cialis was first approved for ED on November 21st, 2003.⁶ It was the third PDE5 inhibitor to come onto the market (after Levitra [vardenafil]).⁷

Which one lasts for longer?

Cialis has an advantage over Viagra and Levitra in that it lasts for a lot longer – 36 hours, compared with 4-5 hours for Viagra and Levitra.^1,2,7 A generic for Cialis was approved in May 2018 and released in September 2018.

How quickly do Cialis and Viagra work and does food have any effect?

Cialis generally works within 16 to 45 minutes, and its activity is not affected by food.

Viagra generally works within 30 minutes, and its effect may be diminished if taken soon after a high fat meal (which may also delay how fast it works). For this reason, Viagra is best taken on an empty stomach.^1,2,7

Effectiveness of all PDE5 inhibitors is similar; although reported effectiveness of Viagra, at 84% is slightly higher than that of Cialis at 81%.⁷ However, more men prefer Cialis because of its longer duration of effect.

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