Cialis® is a safe and effective treatment for ED, used by millions since it was approved by the FDA in 2003. To get maximum effect from Cialis while reducing risks for side effects, we must go beyond taking a pill. Are you using Cialis correctly? (Most treatment failures are due to incorrect use!) Are you in the mood to have sex? Are you taking the right dose? How is your physical and mental health? 

It turns out there are multiple factors that affect the effects you get from Cialis. And having one out of whack can stop Cialis from working. If you’re interested in learning how to take Cialis for best results, keep reading. This guide covers how to take Cialis for best results while lowering your risk for side effects. Using Cialis correctly is key to getting the most from treatment. We’ll also discuss what to do if Cialis isn’t working.

How does Cialis work for erectile dysfunction?

What is Cialis (tadalafil)? It’s a prescription medication made by Eli Lilly and Company that’s approved by the Food and Drug Administration (FDA) to treat erectile dysfunction (ED). It’s also approved to treat benign prostatic hyperplasia (BPH).

The generic for Cialis is tadalafil, and it's FDA-approved for the same uses as Cialis. It’s as safe and works as well as brand-name Cialis, and is typically much more affordable.

Cialis (tadalafil) belongs to a medication class called phosphodiesterase type 5 inhibitors. You’ll probably hear them called PDE5 inhibitors, or PDE5 blockers. Other PDE5 blockers include Viagra® (sildenafil), Stendra (avanafil), and Levitra (vardenafil).

PDE-5 is an enzyme (a special type of protein) found throughout your body, including in your blood vessels. PDE-5 inhibitors like Cialis and Viagra block PDE-5. Blocking PDE-5 in blood vessels causes blood vessels to relax and open. Relaxing blood vessels increases blood flow, including to the penis to cause and maintain an erection.

How does Cialis work for erectile dysfunction?

What is Cialis (tadalafil)? It’s a prescription medication made by Eli Lilly and Company that’s approved by the Food and Drug Administration (FDA) to treat erectile dysfunction (ED). It’s also approved to treat benign prostatic hyperplasia (BPH).

The generic for Cialis is tadalafil, and it's FDA-approved for the same uses as Cialis. It’s as safe and works as well as brand-name Cialis, and is typically much more affordable.

Cialis (tadalafil) belongs to a medication class called phosphodiesterase type 5 inhibitors. You’ll probably hear them called PDE5 inhibitors, or PDE5 blockers. Other PDE5 blockers include Viagra® (sildenafil), Stendra (avanafil), and Levitra (vardenafil).

PDE-5 is an enzyme (a special type of protein) found throughout your body, including in your blood vessels. PDE-5 inhibitors like Cialis and Viagra block PDE-5. Blocking PDE-5 in blood vessels causes blood vessels to relax and open. Relaxing blood vessels increases blood flow, including to the penis to cause and maintain an erection. 

How long does it take Cialis to work?

Cialis (tadalafil) typically doesn’t take long to work, but this will vary from person to person.

Taking Cialis as needed. The dosages for taking Cialis as needed range from 5 mg to 20 mg. After you take a dose of Cialis or tadalafil, you may be able to have sex after about 30 minutes. This may be as little as 15 minutes for some people, while it may take 1 or 2 hours in others. Cialis reaches its peak between 30 minutes to 6 hours after a dose, averaging about 2 hours.

Taking Cialis daily. The dosages for taking Cialis daily are 2.5 mg to 5 mg taken once per day. Cialis (or tadalafil) begins working with your first dose. Similar to as-needed use, it can take as little as 15 minutes or around 2 hours before you’re ready for sex after the first dose. But after this, you won’t need to time sex around your Cialis doses. You can take your dose at a time convenient for you because you’ll always be ready for sex.

How long does Cialis last?

When used as-needed, the effects of Cialis (or tadalafil) last for up to 36 hours after one dose.

When taken daily, Cialis’ effects continue until you stop taking the medication. This means you’re ready for sex regardless of when you take your dose. If you stop taking Cialis (or tadalafil) after taking it daily, it can remain in your system for about 3 to 4 days. So after your last daily dose, the effects of Cialis may last a few days.

How to take Cialis for best results

How to get maximum effect from Cialis (tadalafil) for erectile dysfunction depends on a few factors. 

Cialis dosage

Your Cialis dosage will depend on whether you’re taking Cialis daily or taking it as-needed.

Cialis as needed

For treatment of erectile dysfunction, Cialis may be taken as-needed. The usual recommended starting dosage is 10 mg taken prior to sex. The dose ranges from 5 mg to the maximum dose of 20 mg. 

It’s important to note that “as needed” does not mean you can take multiple doses over a 24 hour period. Follow your doctor’s directions and do not take more than one dose per day.

Cialis daily

Cialis can be taken daily to treat erectile dysfunction (ED), BPH, or both ED and BPH. With Cialis daily use, you don’t need to time your dose around sex.

The recommended starting dosage for Cialis daily use for ED is 2.5 mg once per day. This can be increased to 5 mg once per day.

If you’re taking Cialis daily for BPH, or to treat ED and BPH, the recommended dosage is 5 mg taken once per day.

When to take Cialis for maximum effect

If you’re using Cialis (tadalafil) as needed, try and take your dose about 30 minutes before sex. 

If you’re taking low-dose daily Cialis, take your dose at a convenient time that you’ll remember each day. The timing of your dose won’t affect the effects you get from Cialis. But you should take your dose at the same time each day. Avoid taking your doses too close together - for example, taking a dose in the evening and then a dose the following morning may raise your risk for side effects.

You can take Cialis with or without food. Food and timing of meals won’t affect how fast Cialis works. If you have side effects such as indigestion, taking your dose with a small meal or snack may help.

Cialis drug interactions

A drug interaction happens when a medication or substance affects how another medication or substance acts in the body. Some interactions are more severe than others. With some interactions, you’ll need to avoid combining medications entirely. With other interactions, your healthcare provider may prescribe a lower dose or monitor you closely for side effects.

Some Cialis drug interactions and what may happen are listed below. This list does not contain all possible Cialis drug interactions. Talk with your healthcare provider if you need medical advice on whether another prescription medication or supplement you take interacts with Cialis.

Medications that interact with Cialis (tadalafil):

• Other PDE5 inhibitors such as Levitra (vardenafil), Viagra (sildenafil), and Stendra (avanafil). You should not take Cialis together with other PDE5 inhibitors.
• Nitrates* such as nitroglycerin and isosorbide mononitrate. You should not take Cialis and nitrates together.
• Alpha-blockers such as tamsulosin
• Certain antibiotics, such as erythromycin
• Certain antifungal medications, including oral ketoconazole
• Guanylate cyclase (GC) stimulators, such as riociguat* (a medication used to treat pulmonary hypertension). You should not use Cialis and GC stimulators together.

Lifestyle and getting the most from Cialis

Getting the best results from Cialis goes beyond taking the medication as prescribed by your healthcare professional.

Both physical and psychological factors contribute to erectile dysfunction symptoms. For some people, the problems may only be physical or psychological. But frequently, both play a role.

Physical contributors to erectile dysfunction include:

• Age
• Tobacco use
• Other health conditions, including diabetes, high blood pressure, and high cholesterol

Psychological contributors to erectile dysfunction include depression, performance anxiety, and stress.

To get the most out of Cialis, work with your healthcare professional on managing lifestyle factors that may contribute to your ED symptoms.

• Treat chronic conditions. If you have a chronic condition that contributes to ED, such as diabetes or high blood pressure, work with your healthcare provider on a treatment plan to manage your conditions. Take any prescribed medications as directed, get regular blood work, and
• Get regular exercise. Don’t stress over doing the “best” workout. Find something you enjoy and stick to it. Weightlifting, running, swimming, boxing, walking, yoga - whatever gets you moving on a regular basis.
• Get enough sleep. Getting enough sleep is key to managing your physical and mental well-being.
• Take care of your mental health. Psychological factors play a major role in sexual arousal and can stop you from getting or maintaining an erection, even if you don’t have a problem with blood flow.

What if Cialis doesn’t work for me?

If Cialis doesn’t work, there are a few factors to consider. But whatever you do, do not take more than one dose of Cialis over a 24-hour period. And don’t change your Cialis dose on your own. This raises your risk for side effects that may be severe.

Instead, consider the following tips:

• Contact your healthcare professional and ask whether your dose should be increased. Again, don’t increase your dose on your own. But if your healthcare professional says it's OK, increasing your Cialis dose may get better results.
• Ask your doctor about switching to daily use. If you are using Cialis as-needed and it doesn’t work, ask your doctor if switching to taking Cialis once daily may work better for you.
• Take a deep breath. Stress alone can be enough to cause erectile dysfunction, and it won’t help your symptoms.
• Make sure “the mood” is right. Cialis won’t “force” you to have an erection. You still need to be aroused, and sexual stimulation is required to get maximum effect from Cialis. Studies of PDE5 inhibitors like Cialis found that up to 81% of treatment failures are due to “incorrect use”, including lack of sexual stimulation.

If Cialis doesn’t work after trying the above tips, your healthcare professional may suggest trying a different treatment option besides Cialis. They may suggest trying a different prescription drug for erectile dysfunction besides Cialis, such as Viagra (sildenafil) or Stendra (avanafil).

Cialis (tadalafil) side effects

Like most medications, Cialis (tadalafil) can cause side effects. But many people are able to take Cialis without issue. And mild side effects often go away on their own in a few hours or days. Mild side effects may go away as your body gets used to Cialis.

Below are some common and serious side effects reported with Cialis. Keep in mind this is not an exhaustive list of all side effects Cialis can cause. Check out the prescribing information to see a complete list, or ask your healthcare professional to learn more.

Common side effects of Cialis

Common side effects reported in studies of Cialis include:

• Back pain
• Flushing
• Headache
• Indigestion
• Muscle pain
• Nasal congestion
• Pain in your arms or legs

People taking Cialis daily reported some additional side effects, including diarrhea, acid reflux, and abdominal pain.

Serious side effects of Cialis

Although not common, Cialis can also cause serious side effects. These include:

• High blood pressure
• Low blood pressure
• Priapism (a painful, prolonged erection requiring immediate medical treatment)
• Sudden vision loss or decrease in vision in one or both eyes
• Hearing loss, including a sudden decrease or loss of hearing
• Allergic reaction

If you have certain heart conditions, including a recent heart attack or stroke, your doctor may not prescribe a PDE5 blocker such as Cialis (tadalafil) or Viagra (sildenafil) to you. This is due to certain risks to the heart.

So before you begin taking Cialis, tell your healthcare provider about your medical history - especially any heart condition you have. Your healthcare provider can weigh in on whether your heart is healthy enough for Cialis. While it’s very unlikely to happen, immediately seek emergent medical care if you have chest pain after taking Cialis or tadalafil.