ED TREATMENT – Medically Reviewed:

Cialis 2026: Prices, Prescriptions & Delivery Options

Michael Chen

Board Certified Urology – Harvard – 18+ Years

Reviewed by our Medical Review Board

Patient Support: (212) 555-0147

Prescription Required Up to 36 Hours Duration Daily or As-Needed Options Not for Heart Patients (Nitrates)

Cialis (Tadalafil) is a PDE5 inhibitor used to treat erectile dysfunction and benign prostatic hyperplasia. Known as the “weekend pill” for its 36-hour duration, it offers flexibility that other ED medications cannot match. However, it requires medical screening for heart conditions and drug interactions.

This medically reviewed guide covers everything patients need to know: how Tadalafil works, proper dosing, critical safety protocols, side effects, and warnings. Whether you are starting treatment or managing long-term therapy, understanding these fundamentals is essential for safe use.

Never Combine with Nitrates

Taking Cialis with nitrates (nitroglycerin, isosorbide) can cause a fatal drop in blood pressure. Always inform your doctor of all medications before starting Cialis.

View Safety Information

What Is Cialis and How It Works

Cialis (Tadalafil) is a PDE5 inhibitor. FDA-approved since 2003 for erectile dysfunction and since 2011 for benign prostatic hyperplasia (BPH).

Unlike Viagra (4-6 hours), Cialis works for up to 36 hours, allowing spontaneous intimacy. It requires sexual stimulation to work – it does not cause automatic erections. It also relaxes prostate muscles, improving urinary flow in BPH patients.

Why Cialis Requires Medical Oversight

Unlike over-the-counter medications, Cialis requires:

  • Medical screening for heart conditions and blood pressure
  • Review of all medications (especially nitrates and alpha-blockers)
  • Evaluation of liver and kidney function
  • Discussion of sexual activity safety for cardiac patients

Conditions Treated with Cialis

Erectile Dysfunction

  • ED (as-needed dosing)
  • ED (daily low-dose)
  • Performance anxiety
  • Post-prostatectomy ED

Prostate Health

  • Benign prostatic hyperplasia (BPH)
  • BPH with ED (combined treatment)
  • Lower urinary tract symptoms
  • Prostatitis (adjunct)

Pulmonary

  • Pulmonary arterial hypertension (Adcirca)
  • High-altitude pulmonary edema (off-label)
  • Raynaud’s phenomenon (off-label)
  • Scleroderma-related PAH

Other Uses

  • Exercise-induced pulmonary hemorrhage (horses)
  • High-altitude sickness prevention
  • Antidepressant-induced sexual dysfunction
  • Peyronie’s disease (adjunct)

Dosage Guidelines

CRITICAL: Dosage must be determined by your physician. Never self-adjust or share medication.

Condition / Use Typical Dose Frequency Duration
ED (as-needed) 10mg Before activity Up to 36 hours
ED (daily) 2.5-5mg Once daily Continuous
BPH 5mg Once daily Long-term
PAH (Adcirca) 40mg Once daily Long-term

*These are general guidelines only. Your physician will determine exact dosing based on your individual medical profile.

Safety & Warnings

Cardiovascular Emergency Warning

If you experience chest pain, dizziness, or nausea during sexual activity after taking Cialis, stop immediately and seek emergency care. This may indicate a serious heart problem.

  • Chest pain or pressure during sexual activity
  • Dizziness, lightheadedness, or fainting
  • Nausea or vomiting with exertion
  • Pain radiating to jaw, arm, or back

Sexual activity can strain the heart. Cardiac clearance is required for patients with heart disease.

Side Effects

Common Side Effects

  • Headache (15% of patients) – usually mild
  • Back pain or muscle aches (5-10%) – resolves in 24-48 hours
  • Facial flushing (3%) – temporary
  • Indigestion (2%) – take with food
  • Stuffy nose (2%) – decongestant may help

Serious Side Effects – Seek Medical Attention

  • Sudden vision loss (NAION) – seek immediate care
  • Sudden hearing loss or ringing in ears
  • Priapism (erection lasting >4 hours) – emergency
  • Severe allergic reaction (swelling, difficulty breathing)
  • Chest pain or irregular heartbeat during activity

Who Cannot Take Cialis?

Absolute Contraindications

  • Use of nitrates (nitroglycerin, isosorbide) – fatal blood pressure drop
  • Use of recreational drugs (“poppers” – amyl nitrite)
  • Severe heart disease or recent heart attack/stroke
  • Hypersensitivity to tadalafil

Use With Extreme Caution

  • Alpha-blockers (doxazosin, tamsulosin) – may cause hypotension
  • Blood pressure medications – additive hypotensive effect
  • Liver or kidney disease – dose adjustment required
  • Retinitis pigmentosa or severe vision loss history
  • Bleeding disorders or stomach ulcers
  • Deformed penis (Peyronie’s, cavernosal fibrosis)

Frequently Asked Questions

Can I buy Cialis online without a prescription?
No. Cialis is prescription-only in the US. Websites offering “no RX Cialis” sell illegal, potentially counterfeit products. Counterfeit Cialis has been found to contain dangerous substances including paint, printer ink, and unlisted drugs.
How long does Cialis last?
Up to 36 hours – earning it the nickname “the weekend pill.” This does not mean a constant erection for 36 hours; it means the ability to achieve erections when sexually stimulated during this window. Effects begin 30-60 minutes after taking.
What if I miss a dose?
For as-needed dosing: take before sexual activity – no daily schedule.
For daily dosing: take as soon as you remember. If close to next dose, skip it. Never double up.
Can I drink alcohol while taking Cialis?
Moderate alcohol (1-2 drinks) is generally safe. However, excessive alcohol can reduce effectiveness and increase side effects (dizziness, headache). Heavy drinking also causes ED independently.
Is Cialis better than Viagra?
Different, not necessarily better. Cialis lasts 36 hours vs Viagra’s 4-6 hours. Cialis offers daily low-dose option. Viagra works faster (30 min vs 45 min). Choice depends on lifestyle, medical history, and personal preference. Both require prescriptions.

Sources & References

  1. U.S. Food and Drug Administration. Cialis (Tadalafil) Prescribing Information. Revised 2022. fda.gov
  2. MedlinePlus. Tadalafil. U.S. National Library of Medicine. medlineplus.gov
  3. American Urological Association. ED Treatment Guidelines. auanet.org
  4. National Institutes of Health. BPH Treatment Guidelines. niddk.nih.gov

Need Help With Your ED Treatment?

Our patient support team can explain dosing options, answer questions about side effects, and connect you with a licensed urologist for personalized care.

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Prescription requires medical consultation and cardiac screening. Not for patients taking nitrates. Available at 35,000+ pharmacies nationwide.

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Cialis is a prescription medication for erectile dysfunction and BPH. Never start, stop, or change your dose without consulting a qualified healthcare provider. Sexual activity may strain the heart – cardiac clearance is required for patients with cardiovascular conditions.

Editorial Standards: Content is medically reviewed by Michael Chen, MD, a board-certified Urology. Last medically reviewed and updated on May 12, 2026. We regularly update this page to reflect the latest FDA guidelines and clinical research.

Emergency Notice: If you experience chest pain, dizziness, or nausea during sexual activity after taking Cialis, or an erection lasting more than 4 hours, seek emergency medical attention immediately.

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