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.
Cialis is another medication used to treat erectile dysfunction (ED), similar to Viagra (sildenafil). The active ingredient in Cialis is tadalafil. Like Viagra, Cialis belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. These drugs work by increasing blood flow to the penis during sexual stimulation, helping men achieve and maintain an erection.
Here are some key points about Cialis:
- Duration of Action: One notable difference between Cialis and Viagra is the duration of action. While Viagra typically lasts for about 4 to 6 hours, the effects of Cialis can last up to 36 hours. Due to this prolonged duration, Cialis is sometimes referred to as the “weekend pill,” as a single dose can provide erectile support for much of the weekend.
- On-Demand vs. Daily Use: Cialis is available in two formulations—on-demand use and daily use. On-demand Cialis is taken as needed, typically 30 minutes before sexual activity. Daily Cialis, on the other hand, involves taking a lower dose of tadalafil every day, regardless of sexual activity. This allows for more spontaneity in sexual encounters.
- Medical Uses: In addition to treating ED, Cialis is also prescribed for the treatment of benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate gland. It can help relieve symptoms such as difficulty urinating and the need to urinate frequently.
- Off-Label Uses: Like Viagra, Cialis may have off-label uses, meaning it might be prescribed for conditions not officially approved by regulatory agencies. Some studies have explored the potential use of tadalafil in the treatment of pulmonary arterial hypertension and lower urinary tract symptoms.
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.
Who may not be Able to Take Tadalafil ?
Tadalafil is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:
- have ever had an allergic reaction to tadalafil or any other medicine
- are taking medicines called nitrates for chest pain (angina)
- have a serious heart and liver problem
- have recently had a stroke or a heart attack
- have low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
- have ever lost your vision due to reduced blood flow to the eye
- have sickle cell anaemia (an abnormality of red blood cells)
- have leukaemia (cancer of blood cells)
- have multiple myeloma (cancer of bone marrow)
- have Peyronie’s disease (curved penis) or a similar problem with your penis
- have a liver or kidney condition
- have a heart condition – your doctor will advise you whether your heart can take the additional strain of having sex
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.
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 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.
Dosage and Strength
Tadalafil comes as 2.5mg, 5mg, 10mg and 20mg tablets.
Dose for erectile dysfunction
The usual dose of tadalafil for erectile dysfunction is 10mg when you need it. Do not take more than 1 tablet a day.
Your doctor may increase or decrease your dose, depending on how well it works and how often you take it.
The effects may last longer than 24 hours, so you’re not recommended to take the 10mg or 20mg tablets every day.
For the tablet to work properly, you’ll need to be sexually excited.
Dose for benign prostate enlargement
Tadalafil for an enlarged prostate comes as 2.5mg or 5mg tablets. The usual dose is 5mg, taken once a day.
If you’re being treated for both benign prostate enlargement and erectile dysfunction, the dose is 5mg.
Dose for pulmonary hypertension
Tadalafil for pulmonary hypertension comes as 20mg tablets.
The usual dose is 40mg – two 20mg tablets, taken once a day.
If you have kidney or liver problems your doctor might decrease the starting dose to 10mg or 20mg.
How Should I take Cialis?
Tadalafil (Cialis) is one of the most popular erectile dysfunction (ED) drugs. Its major appeal? The drug comes in low-dose versions that can be taken daily. This means you can have sex at any time, rather than needing to take a pill from time to time as needed like other ED brands.
The starting dose for daily-use Cialis is 2.5 milligrams (mg). If that doesn’t work, you can increase your daily dose up to 5 mg. But is this the right approach for you—or are you better off with traditional ED drugs like Viagra, Levitra, or even the nondaily version of Cialis? If you are contemplating Cialis for daily use, consider these questions and then discuss it with your doctor:
- How often do you have sex? If it’s two or more times a week, a daily pill might be a reasonable choice, since the drug continually circulates in your bloodstream.
- How important is spontaneity? A daily pill clears the path for sex at any time—if the drug works for you. (Remember, just like other ED drugs, it may not work for everyone). On the other hand, the 36-hour window offered by the nondaily version of Cialis might offer enough spontaneity.
- Have side effects of your current ED pill been bothering you? Taking a daily low-dose pill may reduce side effects, though it may reduce effectiveness as well. In studies, the most common daily pill side effects were headache, muscle pain, indigestion, and back pain.
- How much alcohol do you drink? Men taking Cialis for daily use can experience a worrisome drop in blood pressure if they drink too much.
- What other medications do you take? Ask your doctor if any medications or supplements you take might interact with a daily erectile dysfunction pill, including blood pressure drugs, antifungal drugs, and HIV drugs. Also, men taking nitrate medications are advised not to take any ED drugs.
- How important is cost? While the manufacturer suggests that a 30-day supply of daily Cialis should cost about the same as eight pills of 36-hour Cialis a month, there’s no way to enforce this. Check your insurance policy and local pharmacies for price information.
Cialis Mechanism of Action
Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and the smooth muscle of the corpus cavernosum. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic guanosine monophosphate (more commonly known as cyclic GMP or cGMP) in smooth muscle cells. cGMP relaxes smooth muscle and increases blood flow to the corpus cavernosum.
The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP.[medical citation needed] Tadalafil (and sildenafil and vardenafil) inhibits PDE5. However, because sexual stimulation is required to initiate the local penile release of nitric oxide, tadalafil’s inhibition of PDE5 will have no effect without sexual stimulation.[3]
Duration of action
Although sildenafil, vardenafil, and tadalafil all work by inhibiting PDE5, tadalafil’s pharmacologic distinction is its longer half-life (17.5 hours), compared to sildenafil and vardenafil, which are both 4–5 hours. This translates to a longer duration of action, which is partly responsible for “The Weekend Pill” nickname. Furthermore, the longer half-life is the basis for tadalafil’s daily therapeutic use in treating pulmonary arterial hypertension.
Comparison with actions of other PDE5 inhibitors
Sildenafil and vardenafil inhibit PDE6, an enzyme found in the eye, more than tadalafil. Some sildenafil users see a bluish tinge and have a heightened sensitivity to light because of PDE6 inhibition.
Sildenafil and vardenafil also inhibit PDE1 more than tadalafil. PDE1 is found in the brain, heart, and vascular smooth muscle. It is thought that the inhibition of PDE1 by sildenafil and vardenafil leads to vasodilation, flushing, and tachycardia.
Tadalafil inhibits PDE11 more than sildenafil or vardenafil. PDE11 is expressed in skeletal muscle, the prostate, the liver, the kidney, the pituitary gland, and the testes. The effects on the body of inhibiting PDE11 are not known.
What happens if I miss a dose?
As Cialis is used as needed, you are not likely to be on a dosing schedule.
If you have:
- benign prostate enlargement – take it as soon as you remember and then continue as usual
- pulmonary hypertension – take it within 8 hours if you can. If you remember after 8 hours, skip the missed dose and take the next dose at the usual time
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.
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.
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.
Tadalafil and Pregnancy
Tadalafil is not often prescribed in pregnancy, but it may be recommended if you have pulmonary hypertension.
Pulmonary hypertension is an extremely serious condition in pregnancy. If you have this condition, it’s important to use reliable contraception (for example a contraceptive implant or a coil) and to talk to your doctor before trying for a baby. You heart condition will need to be assessed so that you can be given information on the risks of pregnancy to your health.
If you become pregnant while taking tadalafil, you will usually be recommended to continue to take it throughout pregnancy. This is because the risks from pulmonary hypertension are potentially life-threatening without treatment.
It’s important to let your doctors know that you are pregnant as early as possible. This is because you will need to be reviewed in a specialist pregnancy and heart clinic throughout your pregnancy. You will be considered a high-risk pregnancy and will have a lot of additional care.
Tadalafil and breastfeeding
If you are breastfeeding and have pulmonary hypertension, tadalafil is not usually prescribed, unless a specialist recommends it.
Tadalafil and fertility
There’s no evidence to suggest that taking tadalafil will reduce fertility in either women or men.
However, speak to a pharmacist or doctor before taking it if you’re trying to get pregnant.
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.
Cialis Take 30 Minutes to Work and Lasts for up to 36 Hours
Cialis usually takes about 30 minutes to take effect with sexual stimulation and its effect lasts for up to 36 hours, which is why it is sometimes referred to as a “weekend pill”.
Talk with your doctor. You may need to try a different erectile dysfunction medication, such as Viagra, or Levitra. It is possible that a different drug will be more effective for you.
If pills do not work, other options are available. Testosterone may be prescribed by either skin patch or injection, especially if the problem is related to age. Alprostadil, injected at the penis or inserted as pellets, improves blood flow to the penis. This technique is usually more effective than medications taken by mouth.
For some patients, a vacuum pump or penile prosthesis (implant) may also be recommended or required.
Cialis (tadalafil) relaxes muscles of the blood vessels and increases blood flow to particular areas of the body. Cialis is used to treat erectile dysfunction ED and symptoms of benign prostatic hypertrophy (enlarged prostate).
Cialis is available in four different dosages of 2.5mg, 5mg, 10mg and 20mg. 20mg is the maximum dosage of Cialis, taking more will not help.