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Cialis is the brand name for tadalafil, a drug used to treat erectile dysfunction. It is similar to Viagra and Levitra. Under the brand name Adcirca, tadalafil is used for pulmonary arterial hypertension.

Cialis increases blood flow to the penis, and this enables a man to achieve an erection. It does not lead to sexual arousal. It should be used with caution, and only under medical supervision.

Tadalafil was approved by the United States (U.S.) Food and Drug Administration (FDA) in 2003 for the treatment of erectile dysfunction (ED).  It is also used to treat pulmonary arterial hypertension and benign prostatic hyperplasia, a condition in which the prostate gland becomes enlarged, causing problems with urination.

Fast facts on Cialis:

Here are some key points about Cialis. More detail is in the main article.

      • Under the name Cialis, tadalafil is used to treat erectile dysfunction.
      • As Adcirca, the same drug treats pulmonary arterial hypertension and benign prostatic hyperplasia.
      • Cialis increases blood flow to the penis, enabling an erection to occur when a man is sexually stimulated.
      • Anyone with a heart condition should seek medical advice before using Cialis.
      • Cialis is a medication, with potentially serious adverse effects. It should only be obtained from a reputable source and used under medical supervision.

How it works

Cialis used as a medication for erectile dysfunction.

Penile erection occurs when the penis fills with blood. This happens because the blood vessels that bring blood flow to the penis dilate, increasing the blood supply. At the same time, the blood vessels that remove blood from the penis contract. The blood accumulates in the penis, causing an erection.

When a man is sexually stimulated, nitric oxide is released into the penis. Nitric oxide enables the production of cGMP, which controls the dilation and contraction of the blood vessels that carry blood to and from the penis.

Another substance, PDE5, destroys cGMP. When this occurs, the blood vessels return to their normal size, and the erection ends. Tadalafil stops PDE5 from destroying cGMP. This causes the erection to last for longer.

The muscles of the arteries in the walls of the lungs also contain PDE5, which is why the same drug can also help with pulmonary hypertension treatment.


1.  What is Cialis used to treat?

Cialis is approved for the treatment of men who experience difficulty having and maintaining an erection (impotence).

2.  How does Cialis work?

Cialis works by enhancing the effects of one of the chemicals the body normally releases into the penis during sexual arousal. This allows an increase of blood flow into the penis. An erection is the result of an increase in blood flow into certain internal areas of the penis.

3.  How is Cialis different from the currently approved products for erectile dysfunction (ED)?

Cialis is different from other currently approved products for ED in that it stays in the body longer. However, there were no studies that directly compared the clinical efficacy and safety of Cialis to other products.

4.  How do I take Cialis?

Cialis is taken orally before sexual activity, not more than once daily. Cialis may be taken with or without food. In some patients, the dose strength and maximum frequency of use may be adjusted. For more detailed information consult with your health care provider.

5.  Are there any side effects with Cialis?

As with any drug product, there may be side effects. The most commonly reported side effects in patients treated with Cialis during the testing of the product were:

  • headache
  • indigestion
  • back pain
  • muscle pain
  • flushing
  • stuffy nose

Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by themselves within 48 hours. A small number of patients taking Cialis also reported abnormal vision.

6.  What important information should you know about Cialis?

  • CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with any nitrate medication. You could get dizzy, faint or have a heart attack or stroke.
  • Tell your healthcare provider that you take Cialis. If you need emergency medical care for a heart problem, it will be important for your health care provider to know when you last took Cialis.
  • After taking a single tablet, some of the active ingredient of Cialis remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.
  • Physicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of alpha-blockers and antihypertensive medications.

7.  What should I talk to my doctor about when considering if Cialis is right for me?

Because sexual activity can increase the work of the heart, your doctors should talk to you about your heart’s general condition and if Cialis is right for you. Patients who have a condition called “left ventricular outlet obstruction” from valvular problems or heart muscle enlargement may get side effects such as fainting or light-headedness. Because patients with recent heart attacks or stroke, heart pains (angina), heart failure, uncontrolled blood pressure or uncontrolled irregular heart beats, severe liver disease, and retinal eye problems were not studied with Cialis, Cialis is not recommended for these patients. There may be rare occurrences of priapism or painful, prolonged erections. This is a serious condition that requires immediate medical attention. Patients should seek prompt medical attention if their erection lasts longer than four hours.

8.  Who should not take Cialis?

Cialis should not be used by patients taking nitrates (such as nitroglycerin tablets or patches) because the combination of these with Cialis could significantly lower blood pressure and lead to fainting or even death in some men.

9.  Can Cialis be used with other treatments for impotence?

The safety and effectiveness of Cialis when used with other treatments for impotence has not been studied. Combined use could lead to additional lowering of blood pressure, possibly to unsafe levels. Therefore the use of such treatments in combination with Cialis is not recommended.

10. What if I am taking other drugs?

Always discuss with your health care practitioner ALL of the medications you are taking (prescription and over-the-counter) that way, you can receive the best advice for your own situation. Cialis is not recommended for people taking any form of nitroglycerin because the combination may lower blood pressure to an unsafe level.

11.  How will Cialis be supplied?

Cialis will be available as oral tablets in 5mg, 10mg and 20mg strengths.

12. Will Cialis be prescription or OTC (over-the-counter)?

Cialis will be available by prescription only.

13.  When will Cialis be available to pharmacies?

FDA has no control over when products are available in pharmacies after FDA approval for marketing. The decision of availability is completely up to the company marketing the product. For further information contact your pharmacist or Eli Lilly and Company directly.

14.  How can I report a serious side effect with Cialis to FDA?

FDA encourages anyone aware of a serious side effect, including consumers or patients, to make a MedWatch report.

You can report an adverse event either online, by regular mail or by fax, using the contact information at the bottom of this page.

How to Take Cialis: 4 Tips to Get the Best Results

How does Cialis treat ED?

Much like Viagra, Cialis relaxes the smooth muscles and arteries inside the penis. At the same time, it also increases blood flow to the penis. When aroused, this combination of relaxation and increased blood flow allows the penis to fill with blood, which results in an erection. It’s important to remember that Cialis only works if you are sexually aroused.

If you’re using Cialis for the first time, here are a couple things to know upfront.

How quickly does Cialis work?

First, Cialis works relatively quickly but not as fast as Viagra. It can take 1 – 2 hours for the full effects of Cialis to kick in, though it only takes about an hour for Viagra to work fully.

How long does Cialis last?

On the other hand, the effects of Cialis last noticeably longer than the effects of Viagra, normally up to 36 hours. That’s a full 1.5 days!

Don’t be alarmed, though; that doesn’t mean you’ll have an erection for 1.5 days straight. That would be an emergency, which we’ll talk about soon. But you may be able to achieve an erection with the help of Cialis throughout the 36-hour time period. This is one of the reasons some men prefer Cialis; it allows for more spontaneous sexual activity.

If your erection lasts longer than 4 hours, even if it’s not painful, consider it a medical emergency. Known as priapism, this condition can cause permanent damage to the tissue that allows you to become erect. People with sickle cell anemia, multiple myeloma, leukemia, and some penile deformities are more likely to have a prolonged erection.

Here are a few tips for taking Cialis safely and effectively:

1) Follow safe, recommended doses.

If you’d like to take Cialis for ED, you’ve got two options: You can take one of the higher-dose tablets on an as-needed basis (i.e., only when you want to have sex), or you can take a smaller-dose tablet every day.

A 10 mg tablet is usually recommended for as-needed use, though some men might find that a lower (5 mg) or higher (20 mg) dose works better.

If you decide to take Cialis daily, the dose is usually 2.5 mg. Since Cialis is a prescription medication, your doctor will help you figure out exactly what dose to take.

For the most part, there’s no way to make Cialis work faster or keep your erection longer. For example, taking the medication with or without food won’t make a difference. However, some things can speed up how quickly Cialis stops working—read on.

3) Watch out for interactions with other medications.

Taking certain medications like phenytoin, fosphenytoin, carbamazepine, and rifampin, or supplements like St. John’s Wort, can cause your body to eliminate Cialis from your system faster. If you are taking these medications, it’s important to continue taking them as prescribed, but taking them separately from Cialis may be helpful.

4) Know the potential side effects.

Aside from a prolonged erection, which is an emergency, possible side effects of Cialis include flushing, headache, nasal congestion, heartburn, back pain, and muscle pain. Additionally, patients taking Cialis daily may also experience pharyngitis and other respiratory infections, cough, diarrhea, UTIs, acid reflux, and abdominal pain.

You might wonder how long you can safely use Cialis. Right now, there isn’t a maximum period of time for safely taking the medication. But as the years pass, you may begin taking other drugs, such as blood pressure or antifungal medications that could be dangerous if combined with Cialis, Viagra, and similar ED drugs. Always be sure any doctor you see knows that you take Cialis so that your medications can be adjusted safely.