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

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.

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.

Cialis (tadalafil) is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5) for the treatment for erectile dysfunction. Tadalafil along with sildenafil (Viagra, Pfizer) and vardenafil (Levitra, Bayer), belongs to a class of smooth muscle relaxants called phosphodiesterase (PDE) inhibitors.

It is approved for the treatment of erectile dysfunction for up to 36 hours after dosing.

The recommended dose of Cialis is 10 mg, taken prior to anticipated sexual activity. The dose may be increased to 20 mg or decreased to 5 mg.

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How will Cialis be supplied?

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


Can Cialis be used with other treatments for impotence?

dr. Alex : 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.

How should I use Cialis?

For the treatment of erectile dysfunction:

On-demand dosing:

The usual recommended dose is 20 mg taken as needed, at least 30 minutes before sexual activity. This medication has been shown to be effective within 30 minutes of taking the tablet, and last up to 36 hours later. As the amount of time tadalafil takes to work varies from person to person, starting sexual activity at different times after taking the tablet will determine the optimal time for sexual activity. The maximum recommended amount of medication to take is one tablet a day.

Mechanism of Action

Erections are caused by increased blood flow from the relaxation of penile arteries and corpus cavernosal smooth muscle. Cyclic GMP (cGMP) causes smooth muscle relaxation and increased blood flow into the corpus cavernosum. During sexual stimulation, tadalafil will inhibit phosphodiesterase type 5 PDE5, which increases the amount of cGMP in smooth muscles cells thus enhancing erectile function.

Preclinical studies showed that tadalafil is over 10,000-fold more potent for PDE5 than for PDE1, PDE2, PDE4, and PDE7 enzymes, which are found in the heart, brain, blood vessels, liver, leukocytes, skeletal muscle, and other organs.


side effects

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.

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