3 DOSAGE FORMS AND STRENGTHS

The dose may be increased to 20mg or decreased to 5mg.

• Lifestyle factors can influence both ED and BPH and the effectiveness of treatment.
• Smoking damages blood vessels and can worsen erectile dysfunction.
• Regular physical exercise improves cardiovascular health and blood flow.
• A healthy diet (e.g., Mediterranean) supports vascular function.
• Obesity is a risk factor for ED and can reduce testosterone levels.
• Limiting alcohol consumption can improve erectile function.
• Managing stress through techniques like meditation can be helpful.
• Adequate, quality sleep is important for hormonal balance and overall health.
• Treating underlying conditions like diabetes and hypertension is crucial.
• Lifestyle changes can enhance the effectiveness of Cialis.
• Discuss lifestyle modifications with your healthcare provider.

It should not be taken more than once a day. The recommended starting dose for Cialis intended for once-daily use is 2.5mg, taken at the same time each day, without regard to the timing of sexual activity. This may be increased to 5mg/day based on need and tolerability. May be taken with or without food.

8.1 Pregnancy

other medicines to treat high blood pressure (hypertension) medicines called HIV protease inhibitors, such as ritonavir (Norvir®, Kaletra®) CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Take CIALIS exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Some men can only take a low dose of CIALIS or may have to take it less often, because of medical conditions or medicines they take. Do not change your dose or the way you take CIALIS without talking to your healthcare provider.

Patient resources

Your healthcare provider may lower or raise your dose, depending on how your body reacts to CIALIS and your health condition. CIALIS may be taken with or without meals. If you take too much CIALIS, call your healthcare provider or emergency room right away. There are two ways to take CIALIS: Do not take CIALIS more than one time each day. Take one CIALIS tablet before you expect to have sexual activity. Cialis is available as a generic, under the name tadalafil.

Product	Dosage	Quantity + Bonus	Price
Cialis Generic	20mg	180 + 10 Pills	254.09€ 241.99€	Buy
Cialis Super Active	20mg	60 + 8 Pills	230.32€ 219.35€	Buy
Cialis Black	80mg	360 + 20 Pills	639.78€ 609.31€	Buy
Cialis Super Active	20mg	120 + 16 Pills	382.15€ 363.95€	Buy
Cialis Generic	5mg	90 + 6 Pills	115.91€ 110.39€	Buy
Cialis Generic	20mg	90 + 6 Pills	154.71€ 147.34€	Buy
Cialis Generic	40mg	60 + 6 Pills	130.98€ 124.74€	Buy
Cialis Generic	20mg	120 + 8 Pills	188.15€ 179.19€	Buy
Cialis Soft Tabs	20mg	30 + 4 Pills	87.43€ 83.27€	Buy
Cialis Generic	10mg	60 + 6 Pills	105.81€ 100.77€	Buy

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: A headache, dyspepsia, back pain, nasal congestion, and flushing are the most commonly reported side effects. Other side effects include a drop in blood pressure, muscle or limb pain, or conjunctivitis. Rarely, may decrease blood flow to the optic nerve causing sudden vision loss. The risk is greater in people aged older than 50, with diabetes, heart disease, high blood pressure, high cholesterol, who smoke, or with certain pre-existing eye problems.

14.1 CIALIS for Use as Needed

Cialis is also used to treat the signs and symptoms of benign prostatic hyperplasia (BPH). Cialis is available as a lower-strength tablet that can be taken daily basis, eliminating the need to 'plan' for sex. Cialis is also available as an 'as needed' tablet. The effect of one tablet lasts for up to 36 hours. The recommended 'as needed' dose for Cialis is 10mg, taken before anticipated sexual activity. The dosage of Cialis may need to be reduced in men with kidney disease.

6.2 Postmarketing Experience

Your healthcare provider may change your dose of CIALIS depending on how you respond to the medicine, and on your health condition. Do not take CIALIS more than one time each day. Take one CIALIS tablet every day at about the same time of day. You may attempt sexual activity at any time between doses. If you miss a dose, you may take it when you remember but do not take more than one dose per day.

Overdose symptoms

What Should I Avoid While Taking CIALIS? Do not use other ED medicines or ED treatments while taking CIALIS. Do not drink too much alcohol when taking CIALIS (for example, 5 glasses of wine or 5 shots of whiskey). Drinking too much alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure. What Are The Possible Side Effects Of CIALIS? For men with CLCR of 30 to 50 mL/min, a starting dose of 5mg not more than once per day is recommended. The maximum dose is 10mg not more than once every 48 hours.

1.1 Erectile Dysfunction

In the current study, we aimed to compare the efficacy and safety of once-a-day dosing of tadalafil 5 mg with the 20-mg on-demand formulation in a series of patients who developed ED following curative radiotherapy for PC. Cialis is a brand (trade) name for tadalafil which may be used to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). Cialis (tadalafil) works by blocking the action of an enzyme known as cGMP-specific phosphodiesterase type-5 (PDE-5). This enzyme breaks down cGMP, a substance cialis canada without prescription that induces smooth muscles to relax. Blocking PDE-5 means increased levels of cGMP within the smooth muscles which promotes muscle relaxation and vasodilation (a widening of blood vessels).

Duration of action

High levels of PDE-5 are found in the penis, lungs, and retina. PDE-5 is also found throughout the body within the smooth muscle cells of blood vessels and muscles. Cialis (tadalafil) belongs to the class of medicines known as PDE-5 inhibitors. Cialis is used for the treatment of erectile dysfunction (ED). It increases blood flow to the penis following sexual stimulation and allows men to keep an erection hard enough for sex. For men with CLCR of < 30 mL/min or on hemodialysis, the maximum dose is 5mg not more than once every 72 hours.

Ingredient	Quantity Per Tablet	Function	Source
Tadalafil	20 mg	Main active component	Lilly Laboratories
Croscarmellose	1.5 mg	Disintegrant	Pharmaceutical Grade
Microcrystalline Cellulose	2 mg	Filling agent	Pharmaceutical Supplier
Magnesium Stearate	0.2 mg	Lubricant	Chemical Manufacturer

Once-daily use may not be recommended in men with CLCR < 30 mL/min.

Uses of the Cialis 20 mg Tablets

These are not all the possible side effects of CIALIS. For more information, ask your healthcare provider or pharmacist. Store CIALIS at room temperature between 59° and 86°F (15° and 30°C). Keep CIALIS and all medicines out of the reach of children. Medicines are sometimes prescribed for conditions other than those described in patient information leaflets.

Safety and tolerability assessment

This is a summary of the most important information about CIALIS. For more information you can also visit or call 1-877-CIALIS1 (1-877-242-5471). CIALIS® (tadalafil) is a registered trademark of Eli Lilly and Company. The makers of these brands are not affiliated with and do not endorse Eli Lilly and Company or its products. Prostate cancer (PC) detection has dramatically increased in Western countries with more patients being diagnosed at an earlier stage and at a younger age. For men with mild-to-moderate liver disease (Child-Pugh Class A or B), the dose should not exceed 10mg once per day. Cialis is not recommended in severe liver disease (Child-Pugh Class C).

Side Effect	Incidence Rate	Severity	Recommendations
Headache	Common	Mild	Hydrate, over-the-counter pain relief
Flushing	Common	Mild	Avoid hot environments
Nasal Congestion	Less common	Mild	Use decongestants cautiously
Back Pain	Less common	Mild	Seek medical advice if persists

Rarely, may cause other side effects including hearing loss, or lead to painful erections lasting longer than four to six hours.

• Cialis 20mg is sometimes used off-label for other medical conditions.
• The medication is designed to improve quality of life for men with ED.
• Tadalafil acts by increasing blood flow during sexual arousal.
• Cialis can be used with certain lifestyle adjustments for better results.
• Patients should monitor their response and side effects.
• Cialis 20mg might interact with certain antifungal medications.
• It is sometimes prescribed alongside other ED treatment options.
• The safety profile of Cialis is well established.
• Cialis 20mg helps improve confidence in intimate moments.
• The medication should not be shared with others.
• It is crucial to follow the prescribed dosage.
• Always report any adverse effects to your healthcare provider.

See your doctor immediately if this happens. May not be suitable for some people including those with angina, chest pain, or other heart conditions, liver or kidney problems, blood or bleeding disorders, stomach ulcers, certain eye conditions, a physical deformity of the penis (such as Peyronie's disease), or serious prior hypersensitivity reactions to tadalafil. May interact with some medications including nitrates - the use of Cialis and nitrates is contraindicated because of the severe hypotension that can develop.

13.2 Animal Toxicology and/or Pharmacology

See “What Is The Most Important Information I Should Know About CIALIS?” The most common side effects with CIALIS are: headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. Back pain and muscle aches usually go away within 2 days. Call your healthcare provider if you get any side effect that bothers you or one that does not go away. An erection that won't go away (priapism). Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.

Can Cialis be crushed, split, or chewed?

Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS) reported a sudden decrease or loss of vision in one or both eyes. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS, and call a healthcare provider right away. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS. If you experience these symptoms, stop taking CIALIS and contact a healthcare provider right away. May also interact with other medications including ketoconazole or ritonavir; dosage adjustment is recommended.

Country	Legal Classification	Prescription Required	Sales Channels
USA	Prescription medication	Yes	Pharmacies, online with script
European Union	Prescription drug	Yes	Licensed pharmacies
Australia	Schedule 4 (Prescription Only)	Yes	Authorized pharmacies
India	OTC and prescription (varies)	Usually prescription	Authorized outlets

A lower dosage of Cialis is recommended in men with mild-to-moderate liver disease.

• Future and research: Patents for brand Cialis have expired in many markets.
• This has led to the availability of multiple generic tadalafil products.
• Research continues on other potential uses for tadalafil.
• Investigated for use in Raynaud's phenomenon, female sexual arousal disorder.
• Studies on its effect in premature ejaculation have shown mixed results.
• Research into its role in treating lower urinary tract symptoms (LUTS) continues.
• New formulations (e.g., sublingual, topical) are under investigation for faster onset.
• Long-term cardiovascular outcomes in specific populations are still being studied.
• Personalized medicine may one day guide optimal PDE5 inhibitor selection.
• Digital health tools are emerging to support ED diagnosis and treatment adherence.
• Always rely on current, approved prescribing information for medical decisions.

Cialis should be avoided with severe liver disease.

• Cialis 20mg requires a doctor's prescription in most regions.
• Some men prefer Cialis over other ED treatments due to longer effects.
• The medication can sometimes cause back pain or muscle aches.
• Cialis has been widely studied in clinical trials.
• In some cases, Cialis may be less effective with certain health conditions.
• The medication may influence blood pressure levels.
• Cialis 20mg should not be used in combination with riociguat.
• Men should avoid excessive alcohol consumption with Cialis.
• Regular assessment by a healthcare provider ensures safe use.
• Cialis’s long duration makes it suitable for spontaneous activity.
• Generic tadalafil provides a cost-effective alternative.
• Proper storage extends the medication's efficacy.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects.

8.6 Hepatic Impairment

This has translated into an increased number of localized diseases receiving external beam radiotherapy with a curative intent. Successful treatment and longer life expectancy have been accompanied by a raising proportion of patients complaining of erectile dysfunction (ED) as an expression of post-radiation late toxicity. A recent review reported ED rates reaching 24–84% in patients undergoing three-dimensional conformal radiation therapy (3DCRT) for PC [1]. Before the advent of the phosphodiesterase 5 inhibitors (PDE5-I) era only scanty information on post-radiation therapy of ED were available. Treatment of post-radiation ED with PDE5-I has gained little attention so far with only a few published phase II studies 2, 3.

Table 1.

In one of these, sildenafil significantly improved the erectile function (EF) domain of the International Index of Erectile Function (IIEF) compared with placebo with up to 90% of patients being able to perform a successful intercourse using the maximal available dose (100 mg) [2]. Tadalafil (Cialis®, Eli Lilly and Company, Indianapolis, IN, USA), a relatively new selective PDE5-I 4, 5, proved effective in nearly 50% of patients treated with 20 mg on demand in the only trial on post-radiation ED patients currently available [6]. In view of its long half-life (17.5 hours) and steady-state plasma concentrations attained within 5 days of daily dosing [7], a once-a-day therapy formulation has been developed. A study compared 10-mg once-a-day with 20-mg on-demand dosing in an ED population of various etiologies, demonstrating that 72% of men preferred daily therapy [8], with a successful completion of sexual intercourse statistically higher for daily tadalafil than for on-demand dosing. A subsequent randomized trial demonstrated the 5-mg daily dose equally effective but better tolerated than the 10-mg dose [9].