Erectile Dysfunction

How To Take Cialis®: How It Works

March 4, 2021

There are plenty of things that can derail a romantic evening: lousy weather, food poisoning, unexpected guests. One of the more common ones – routinely experienced by an estimated 30 million men in the United States – is erectile dysfunction. 

However, unlike some of the other issues above, there are plenty of ways to prevent erectile dysfunction from ruining a romantic night. One of the most effective ways to treat erectile dysfunction is by taking tadalafil, or as its more commonly known: Cialis®

While sildenafil, also known as Viagra®, is arguably the most popular option and perhaps even the most recognized name in pharmaceuticals, it’s not necessarily the better treatment. In fact, Cialis® is the more versatile option of the two, and its effects last longer. While Cialis® can be more expensive than Viagra®, its versatility may be worth it. 

How Does Cialis® Treat Erectile Dysfunction?

Erectile dysfunction is a result of insufficient blood flow to the penis. While there are many factors that can contribute to this, it’s typically the result of a medical problem, medication, or even psychological issue. 

The way that Cialis® works to fight erectile dysfunction is by helping to relax the smooth muscles and arteries that are located in the penis, in order to increase blood flow. Cialis® is what’s known as a phosphodiesterase type 5, or PDE5, inhibitor. This drug works in the presence of nitric oxide, naturally released during sexual arousal, in order to better relax muscles in the penis and increase blood flow. It helps to release the body's natural brakes on the erection process, keeping blood moving to the penis and in the penis.

Cialis® will only work in the event that a person is sexually aroused, so if there is no nitric oxide being released, then Cialis® will not have any effect. 

How Do You Take Cialis®?

One of the benefits of Cialis® is the diversity of doses. All of the primary PDE5 inhibitors like Viagra®, Cialis® and Levitra® are tablets that are taken orally, but Cialis® is the only option that is safe in a once-daily dose. The other choices are only safe to use “as needed.” 

In addition to the option of being taken daily, Cialis® also has the longest half-life of these medications, meaning that its effects will last the longest. Cialis® comes in a few different sizes, depending on how they are intended to be taken. The four different dosage options for Cialis® are 2.5 milligrams, 5 milligrams, 10 milligrams and 20 milligrams.  

  • “As-needed” doses: Studies have shown that Cialis® is just as effective as Viagra® when taken “as needed.” Not only that, but the effects of Cialis® will last longer than the effects of Viagra®, as long as 36 hours compared to 4 hours for Viagra®. While the effects of Viagra® may be felt faster for some men, Cialis® can stay in your body for up to 36 hours. The typical starting dose is 10 milligrams, which can then be increased or decreased for maximum effect. When taking “as needed” simply take one table around 30 minutes or so before sexual activity is expected to start. It normally takes around 30 minutes for the effects to kick in but may take as long as two hours before the maximum benefits can be felt.

  • Daily doses. The usual starting dose for once-daily Cialis® is 2.5 milligrams. The dosage may be increased up to 5 milligrams but not further. Just like any other daily medication, Cialis® should be taken as prescribed at the same time each day. For people that prefer flexibility for the timing of their sexual activity, daily doses are much preferred to “as needed” and studies have shown lead to an increase in confidence. 

The choice between these options comes down to personal preference, and sometimes trial and error on the part of a patient and their doctor. 


What Are the Side Effects of Cialis
®

Cialis® is considered a safe and effective drug with limited side effects when used according to prescribing information. The most extreme side effect is having a prolonged erection, but that is also the most rare. 

Some of the more common side effects that may be experienced by men taking Cialis® include:

  • Flushing
  • Heachache
  • Nasal congestion
  • Heartburn or acid reflux
  • Back pain or abdominal pain
  • Muscle pain
  • Sore throat
  • Respiratory infections
  • Cough
  • Diarrhea
  • UTIs

The most important thing to keep in mind about the side effects of Cialis® is what could happen if you combine medications. Certain medications that treat high blood pressure can cause extremely low blood pressure when combined with Cialis®. If you're taking any kind of nitrate medications like nitroglycerin in order to treat angina or blood pressure issues then you should avoid Cialis® and all other PDE5 inhibitors. 

Cialis® should never be taken if you are already using:

  • Nitroglycerin tablets, sprays or patches
  • Isosorbide mononitrate (Imdur, Ismo, Monoket)
  • Isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate)
  • Alpha blockers (Terazosin, Tamsulosin, Doxazosin, Afuzosin, Silodosin)
  • Azole antifungals (Ketoconazole, Itraconazole)
  • Macrolide antibiotics (Erythromycin, Clarithromycin, Telithromycin)

There are other medications and substances that can reduce the effectiveness of Cialis® too. Mixing these are likely not as potentially fatal as the list above, but they should also be avoided if possible:

  • Phenytoin
  • Fosphenytoin
  • Carbamazepine
  • Rifampin
  • St. John’s Wort

How To Maximize the Effects of Cialis 

For the most part, taking Cialis® is a compelling and effective way to eliminate the symptoms of erectile dysfunction. However, there are plenty of ways to increase its effectiveness and reduce the frequency of erectile dysfunction as well. The things that you eat and drink can have an effect on the chemicals and composition of your body, which will impact the effectiveness of Cialis®

Some of the best ways to enhance the effectiveness of Cialis® are:

  • Avoid fatty meals before taking Cialis®. If you're taking Cialis® “as needed” then this step can be important. If you eat foods high in fat, such as meat and cheese, before taking the drug then you may delay the onset of its effects. These heavy and fatty moods will result in blood being diverted to your digestive system in order to help to break them down, as well as reduce the absorption of Cialis® to the bloodstream. This diversion will result in less blood being available to go toward the penis and will hurt the effectiveness of Cialis®. In addition, it’s best to avoid grapefruit when possible as this seems to have a negative impact on Cialis® as well. If you're expecting to engage in sexual activity, it’s best to eat a light meal beforehand.

  • Drink less alcohol. The ethanol that's found in alcoholic beverages affect the absorption and effectiveness of all types of medications and is true for PDE5 inhibitors as well. Alcohol will prevent Cialis® from being used by your body in the way that it’s intended to be. Chronic alcohol consumption, and binge-drinking, are some of the main causes of erectile dysfunction in the first place, so reducing your intake can have multiple positive benefits.

  • Maintain a healthy lifestyle. The absolute best way to maximize the effects of Cialis® and reduce the frequency of erectile dysfunction is to maintain a healthy weight and diet. Erectile dysfunction is the result of an inadequate blood flow to the penis, and this can be improved in several different ways. Having a body mass index over 25 will significantly increase the chances of erectile dysfunction, worse the higher your BMI. Obesity and diabetes are often causes of erectile dysfunction, and losing weight will help to reduce your body mass index and the chances of developing diabetes. Getting regular exercise will help improve blood flow in your body and lower stress, which is another common cause of issues relating to sexual function. If you currently smoke, then stopping is one of the single fastest ways to fight erectile dysfunction, as nicotine is known to reduce blood flow, and smoking can damage the heart and lungs. 

  • Communicate and relax. There's more to sexual function than physical reactions in the body – there's a deeply important mental and emotional side to ED and sexual function as well. Being stressed out can have a big effect on sexual performance, which in turn can create more stress and further symptoms of ED. If you're experiencing any issues involving your relationship or are experiencing performance anxiety, then it may be a good idea to work with a therapist or begin practicing de-stressing exercises or mindfulness. Being stressed, anxious, nervous or depressed cannot only cause erectile dysfunction, but make Cialis® not as effective in treating ED.


The Takeaway: Cialis
® is one the most popular treatments for erectile dysfunction for good reason. It's just as effective as other medications but has the added benefit of being more diverse as an ED treatment, with different dosing options and timeframe options. 

Cialis® has all the benefits of the other options for treating erectile dysfunction along with the added benefit of being able to be taken daily, and with an extended timeframe for activity. While Viagra® is often the go-to for most guys because it's so well-known, Cialis® has long been a close second in popularity. When men are able to try both options, they frequently prefer Cialis® over Viagra® due to increased optionality. 

Rex MD helps men access prescription ED medications like Cialis® and Viagra® from home with a virtual physician consultation. While a majority of Rex Md patients choose generic Viagra, we carry all of the most popular ED medications online, and we've helped over 100,000 men order from home. It's simple, easy, and affordable, and it avoids doctor office visits, co-pays, and hassle. 

Sources

Cialis: Dosage, side effects, how to take, and more - Medical News Today

Questions and Answers for Cialis (tadalafil) - FDA