What is Cialis?

Cialis is a prescription medication commonly used to treat erectile dysfunction (ED) in men. It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. By increasing blood flow to the penis, Cialis helps to achieve and maintain an erection during sexual stimulation. It can also be prescribed to treat symptoms of benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate gland. Cialis is usually taken orally as needed, with or without food, and its effects can last up to 36 hours. Common side effects may include headache, indigestion, muscle aches, and back pain.

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What is Cialis?

CIALIS is a tablet used for the treatment of patients with erectile dysfunction, benign prostate hyperplasia, and a combination of erectile dysfunction and benign prostate hyperplasia.

How Does Cialis Work?

CIALIS contains tadalafil. Tadalafil is a phosphodiesterase-5 inhibitor (PDE-5). PDE-5 is found in the penile corpus cavernosum. When sexually stimulated, males release nitric oxide which triggers the production of cycle guanosine monophosphate (cGMP) which causes smooth muscle relaxation. This allows blood to enter the penis and causes an erection. Tadalafil inhibits the breakdown of cGMP and thereby enhances penile erection.

What are the Indications for Cialis?

CIALIS is indicated for the treatment of:

  • erectile dysfunction
  • benign prostate hyperplasia
  • the combination of erectile dysfunction and benign prostate hyperplasia

Dosage

CIALIS is manufactured as a 2.5 mg, 5 mg, 10 mg, and 20 mg tablet. The tablets are almond-shaped and come in different shades of yellow.

For patients with erectile dysfunction the starting dose of CIALIS is 10 mg taken before sexual activity. This can be increased to 20 mg or decreased to 5 mg, depending on how it is tolerated or on the side effects experienced. Erectile function is improved for up to 36 hours after taking CIALIS. It should not be taken more than once a day.

CIALIS for erectile dysfunction may be taken as a 2.5 mg dose daily. This is irrespective of sexual activity timing. This may be increased to 5 mg daily.

CIALIS for benign prostate hyperplasia may be taken at a dose of 5 mg daily. It should be taken at approximately the same time every day.

CIALIS for benign prostate hyperplasia and erectile dysfunction may be taken at a dose of 5 mg daily at approximately the same time every day.

CIALIS can be taken with or without food.

Warnings & Precautions

CIALIS should not be used if a patient has been advised not to have sex because of their cardiovascular risk.

Alcohol, alpha-blockers and antihypertensives

Using CIALIS together with significant amounts of alcohol, or with blood pressure medications such as alpha-blockers or beta-blockers, may lead to hypotension.

CIALIS should not be used at the same time as alpha-blockers when treating benign prostate hyperplasia. This combination has not been adequately studied and there is a significant risk of the patient experiencing low blood pressure. Care should be taken when using CIALIS together with alpha- blockers when treating erectile dysfunction.

Prolonged erection

If an erection lasts more than four hours, emergency medical treatment should immediately be sought.

Eye complications

If a sudden loss of vision occurs in one or both eyes the patient should immediately stop using CIALIS and should seek help. This many be a sign of non-arteritic ischemic optic neuropathy.

Sudden hearing loss

If a sudden loss or acute reduction in hearing is noted, CIALIS should be stopped, and medical help should be sought.

Cardiovascular disease

CIALIS should not be used in patients who have:

  • had a heart attack in the last 90 days
  • unstable angina or angina during sex
  • New Year Heart Association Class 2 or higher cardiac failure in the last six months
  • uncontrolled hypertension, hypotension, or arrhythmias
  • had a stroke in the last 6 months

Special Populations

Renal failure or renal impairment

CIALIS can be used in patients with mild renal impairment. If the creatinine clearance is between 40 to 50 mL/min, an adjustment of the dose may be needed. If the creatinine clearance is less than 30 mL/min, or the patient is on dialysis, the dose should not exceed 5 mg every three days. Using CIALIS once a day is not recommended. The maximum dose of 10 mg every two days should be adhered to.

CIALIS for erectile dysfunction should not be used daily in patients with a creatinine clearance of less than 30 mL/min.

CIALIS for benign prostate hyperplasia and erectile dysfunction should not be used daily in patients with a creatinine clearance of less than 30 mL/min. In patients with a creatinine clearance of between 30 and 50 mL/min, the starting dose should be 2.5 mg daily. The dose may be increased to 5 mg daily if needed.

Hepatic dysfunction

CIALIS can be used in patients with mild to moderate hepatic dysfunction. However, a dosage adjustment may be needed. CIALIS should not be used in patients with severe hepatic impairment.

Elderly

CIALIS has been tested in patients over the age of 75. No differences in safety or efficacy were shown in these patients. Therefore, no dose adjustments are required based on age alone.

Pediatrics

There are no clinical data to determine the safety of CIALIS in pediatric patients. CIALIS should not be used in persons under the age of 18.

Pregnancy

CIALIS is not recommended for use in women. It is not known if CIALIS is excreted into breast milk and so should not be used when breastfeeding.

Contraindications

CIALIS is contraindicated in:

  • Patients taking any type of nitrate. The use of nitrates at the same time as CIALIS can lead to profoundly low blood pressures.
  • Any patient with a known history of hypersensitivity to CIALIS.

Side Effects

Common side effects of CIALIS include:

  • Headache
  • Dyspepsia
  • Back pain
  • Myalgia
  • Nasal congestion
  • Flushing
  • Limb pain

Less common side effects include:

  • Acute vision loss due to non-arteritic anterior ischemic optic neuropathy
  • Sudden hearing loss
  • Priapism – sustained unwanted erections

If any of these side effects are noticed, a doctor should be contacted immediately.

Drug Interactions

Certain drugs may interact with CIALIS. These include:

  • Nitrates
  • Alpha-blockers
  • Antihypertensives
  • Alcohol
  • Ketoconazole
  • Atazanavir
  • Clarithromycin
  • Indinavir
  • Itraconazole
  • Nefazodone
  • Nelfinavir
  • Ritonavir
  • Saquinavir
  • Telithromycin
  • Rifampin

Frequently Asked Questions

CIALIS is manufactured as a 2.5 mg, 5 mg, 10 mg, and 20 mg tablet. The tablets are almond-shaped and come in different shades of yellow.

For patients with erectile dysfunction the starting dose of CIALIS is 10 mg taken before sexual activity. This can be increase to 20 mg or decreased to 5 mg depending on how it is tolerated, or on the side effects experienced. Erectile function is improved for up to 36 hours after taking CIALIS. It should not be taken more than once a day.

CIALIS for erectile dysfunction may be taken as a 2.5 mg dose daily. This is irrespective of sexual activity timing. This may be increased to 5 mg daily.

CIALIS for benign prostate hyperplasia may be taken at a dose of 5 mg daily. It should be taken at approximately the same time every day.

CIALIS for benign prostate hyperplasia and erectile dysfunction may be taken at a dose of 5 mg daily at approximately the same time every day.

Take CIALIS as prescribed by your healthcare provider. The way CIALIS is prescribed differs between men because of the conditions they have or the medications they take. Do not change your dose without first speaking to your healthcare provider. CIALIS can be taken with or without food. The tablet should not be crushed, chewed, or cut.

When taking CIALIS as needed for erectile dysfunction, take a tablet at least 30 minutes before sex. The tablet will be effective up to 36 hours after being swallowed.

You should not take CIALIS if you:

  • Are taking nitrates
  • Use nitrates, such as “poppers”, as recreational drugs
  • Are allergic to CIALIS

CIALIS can cause a significant drop in your blood pressure if you take it with medications called nitrates. Nitrates are used to treat the pain experienced during a heart attack. CIALIS may still be present in your blood for two days after taking the tablet. It is important to tell any healthcare provider that attends to you that you have taken CIALIS.

If you are taking CIALIS daily and you miss a dose, try to take it as soon as possible, then continue with the usual medication schedule. However, if you are due to take your next dose soon, skip the dose you missed and continue with your regular medication schedule. Under no circumstances should you take a double dose of the medication to make up for the missed dose. If you are unsure about what to do, contact your doctor or local pharmacist to obtain advice.

When taking CIALIS, you should avoid using other treatments for erectile dysfunction. Make sure that you don’t drink too much alcohol while on CIALIS. Drinking too much may increase your risk of experiencing a low blood pressure or developing a headache.

Common side effects of CIALIS include:

  • Headache
  • Dyspepsia
  • Back pain
  • Myalgia
  • Nasal congestion
  • Flushing
  • Limb pain

Less common side effects include:

  • Acute vision loss due to non-arteritic anterior ischemic optic neuropathy
  • Sudden hearing loss
  • Priapism – sustained unwanted erections

If any of these side effects are noticed, a doctor should be contacted immediately.

If you experience severe side effects, immediately contact your doctor, or go to the nearest emergency health care facility.

CIALIS should be stored away from children. It should be stored in a dry place at room temperature, away from heat, sunlight, and moisture. It should be stored in a closed container.