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Cialis

Cialis is a popular medication used to treat erectile dysfunction, pulmonary arterial hypertension, and the symptoms of benign prostatic hyperplasia. It increases blood flow to specific areas of the body, helping to achieve and maintain an erection. Cialis is renowned for its long duration of action, lasting up to 36 hours.

A close-up image of a yellow Cialis pill manufactured by Eli Lilly.

Cialis is a widely recognised medication, known generically as tadalafil, designed to treat erectile dysfunction (ED), a condition affecting millions of men worldwide. The 1990s saw the development of tadalafil, which is sold under the brand name Cialis. This was the result of a collaboration between Glaxo Wellcome (now GlaxoSmithKline) and the biotech company ICOS Corporation [1]. Approved by the U.S. Food and Drug Administration (FDA) in 2003 [2], it has become a cornerstone of ED treatment thanks to its unique, long-lasting effects, earning it the nickname 'the weekend pill'. Approval for use in the European Union was granted by the European Medicines Agency (EMA) as early as November 2002 [3].

Developed by the pharmaceutical company Eli Lilly, Cialis emerged from research into phosphodiesterase type 5 (PDE5) inhibitors, a class of drugs that has transformed the management of ED by enhancing blood flow to the penis. Since its approval, Cialis has been prescribed worldwide, providing men with a reliable option to fight ED and enhance their quality of life. Cialis achieved global sales exceeding $1 billion by 2005, just two years after its launch. By early 2005, Cialis had become the leading ED treatment in France, overtaking Viagra in market share [4]. In 2022, approximately 3 million prescriptions for tadalafil (the active ingredient in Cialis) were issued in the US, making it the 172nd most commonly prescribed drug that year [5].

What is Cialis?

Cialis is a pharmaceutical medication containing the active ingredient tadalafil, which is primarily used to treat erectile disorder. It belongs to a class of drugs known as PDE5 inhibitors [6], which work by relaxing blood vessels and increasing blood flow to the penis during sexual stimulation to facilitate an erection. Its distinct profile, including a duration of action of up to 36 hours, sets it apart in the landscape of ED therapies. Unlike some other erection medications, Cialis is notable for its versatility: it is also approved for treating benign prostatic hyperplasia (BPH) and, under a different brand name (Adcirca), pulmonary arterial hypertension (PAH).

The key component of Cialis, tadalafil, inhibits the PDE5 enzyme, which regulates blood flow in the penis. By blocking this enzyme, Cialis helps maintain higher levels of cyclic guanosine monophosphate (cGMP), a molecule that promotes smooth muscle relaxation and blood vessel dilation (more info). These processes are essential for achieving and sustaining an erection. It is important to note that Cialis only works when taken alongside sexual stimulation, as it enhances the body’s natural response rather than causing an automatic erection.

How effective is it?

Cialis has proven highly effective in treating ED in numerous clinical studies. Clinical trials, including those reviewed in the Journal of Sexual Medicine, report that 72–91% of men with erection problems experience improved erections and sexual performance when using Cialis, depending on the dose and any underlying health conditions [7]. A pivotal 2004 study published in the journal Adult Urology found that 59.2% of men taking 20 mg of Cialis reported successful intercourse attempts, compared to 28.3% of those taking a placebo [8].

Users often report noticeable improvements in their ability to achieve and maintain erections sufficient for sexual activity. Cialis is particularly valued for its flexibility, offering both on-demand and daily dosing options. The medication usually takes effect within 30 to 60 minutes, though some men may experience results as quickly as 15 minutes after taking it, according to patient-reported outcomes in studies. Its standout feature is its duration of action, which lasts up to 36 hours. This is significantly longer than that of other PDE5 inhibitors, such as sildenafil (Viagra), which typically lasts 4–6 hours. This extended window allows for greater spontaneity, reducing the need to time sexual activity precisely.

However, effectiveness can vary based on factors such as the severity of ED, underlying health conditions like diabetes or hypertension, and adherence to dosing instructions. Men with mild to moderate ED often report higher success rates, while those with severe ED may require higher doses or additional medical evaluation, as noted in research from the International Journal of Impotence Research [9]. A thorough diagnosis from a healthcare provider is the best way to make sure you get the best possible results.

The benefits of Cialis

Cialis has several distinct advantages for men with impotence, as demonstrated by clinical research and patient-reported outcomes. Its unique properties make it a versatile option that enhances both sexual performance and lifestyle flexibility. The key benefits of Cialis are outlined below:

  • Extended duration of action: Cialis is renowned for its long-lasting effects, remaining active for up to 36 hours. This extended window enables greater spontaneity in sexual activity and reduces the need for medication timing to be planned around.
  • Flexible dosing options: Cialis is available in both on-demand (10 mg or 20 mg) and daily low-dose (2.5 mg or 5 mg) formulations, catering to varied needs. Daily dosing can provide continuous readiness, which is particularly beneficial for men with frequent sexual activity [10].
  • Improved quality of life: Patient-reported outcomes from clinical trials demonstrate that Cialis users often report increased confidence and reduced anxiety regarding sexual performance. This contributes to enhanced overall relationship satisfaction.
  • Additional health benefits: Beyond treating ED, Cialis is approved for treating BPH, alleviating urinary symptoms such as frequent or hesitant urination.
  • Mild side effect profile: Research indicates that most men tolerate Cialis well, with mild side effects such as headaches or indigestion occurring in fewer than 15% of users. This supports its suitability for long-term use under medical supervision.
  • Lifestyle compatibility: Unlike some other ED medications, Cialis can be taken with or without food, which adds convenience. Its long duration also accommodates varied schedules, making it easier to integrate into daily life.

These benefits make Cialis a compelling choice for many men, particularly those seeking flexibility and reliability in managing ED. However, seeking a doctor's guidance is essential to maximise these advantages based on individual health needs.

Who can benefit from Cialis?

Cialis is designed to help men with ED, a condition that affects an estimated 30 million men in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It is suitable for a broad range of men experiencing ED due to various causes, provided they receive a doctor’s evaluation to ensure its safety and suitability. Those who can benefit include:

  1. Men with physical causes of ED: Common physical triggers include diabetes, affecting up to 50% of men with the condition by the age of 60, according to a 2017 study in Diabetes Care, and hypertension, which is linked to ED in 30–50% of cases, according to the American Journal of Hypertension. Cialis improves blood flow, effectively addressing these vascular issues.
  2. Men with psychological causes: Stress, anxiety or depression can contribute to ED. According to the International Journal of Impotence Research, psychological factors play a role in up to 20% of cases [11]. Cialis can support these men by providing reliable performance, which may reduce performance anxiety.
  3. Men with mixed causes: Many men experience ED due to a combination of physical and psychological factors. Cialis's versatility, with both on-demand and daily dosing options, makes it adaptable to varied needs.
  4. Men with BPH: As Cialis is also approved for BPH, men who have both ED and urinary symptoms, such as frequent urination, may benefit from its dual action.

While Cialis is effective for many, it’s not suitable for everyone. Men with certain health conditions, such as severe heart disease, or who are taking nitrates, should avoid it due to potential risks. It is essential to consult a healthcare provider to determine if Cialis is appropriate, especially for individuals with underlying conditions such as cardiovascular disease or low blood pressure. Consulting a doctor ensures safe use and a treatment plan tailored to your needs for optimal results.

Potential risks and side effects

Cialis is generally well tolerated, but, as with all potency remedies, it carries potential risks and side effects that users should be aware of. Clinical studies suggest that most side effects are mild and temporary [12]. However, serious risks, though rare, require immediate attention. It is crucial to consult a healthcare provider before starting Cialis to assess individual risks, particularly for those with pre-existing health conditions.

Common side effects include:

  • Headache
  • Flushing (warmth or redness in the face)
  • Indigestion or an upset stomach
  • Back pain
  • Muscle aches
  • Nasal congestion

These side effects usually clear up within a few hours to a couple of days. Staying hydrated and taking the medication with food may help to manage mild symptoms. However, users should discuss any persistent issues with a doctor.

Rare but serious side effects:

  • Prolonged erection lasting more than 4 hours (priapism), which requires immediate medical attention to prevent tissue damage.
  • There have been extremely rare reports of vision or hearing impairment, which are potentially linked to changes in blood flow. Immediate medical care is essential.
  • Severe allergic reactions with symptoms such as rash, swelling, or difficulty breathing require urgent medical attention.
  • In men with pre-existing heart conditions, rare instances of cardiovascular events such as chest pain or heart attacks have been reported, particularly when combined with nitrates.

Men taking nitrates for heart conditions or with severe cardiovascular issues should avoid Cialis due to the risk of dangerous blood pressure drops. While most side effects are manageable and serious complications are uncommon, it is important to use Cialis as prescribed under medical supervision. Talking to a healthcare provider about any concerns ensures safe and effective use.

Cost and accessibility

Cialis (tadalafil) is widely available through various channels, but its cost and accessibility depend on factors such as dosage, prescription status and whether the brand-name or generic version is chosen. As a prescription-only medication, Cialis requires a doctor's approval to ensure it is used safely and is tailored to an individual's health needs. Below is an overview of Cialis prices and access options based on current market trends and healthcare practices.

Cost range:

  • Brand-name Cialis: Prices typically range from €10 to €25 per 10 mg or 20 mg tablet for as-needed use. A 30-day supply of daily low-dose tablets (2.5 mg or 5 mg) costs between €150 and €400 depending on the pharmacy and country.
  • Generic Cialis: Significantly more affordable, with prices often between €0.40 and €3 per 10 mg or 20 mg tablet for as-needed use. A 30-day supply of daily low-dose tadalafil (2.5 mg or 5 mg) typically costs between €20 and €80.

Availability:

  • Pharmacies: Cialis and generic tadalafil are available at major pharmacies.
  • Telehealth services: Telehealth platforms offer consultations and prescriptions and often deliver directly to patients, which improves convenience for those who wish to avoid in-person visits.
  • Online pharmacies: Reputable online pharmacies provide safe access. Ordering Cialis online is a convenient and discreet way to obtain the medication. However, patients should verify the legitimacy of these pharmacies to avoid counterfeit drugs, which pose significant health risks.

The accessibility of Cialis is enhanced by the widespread availability of generics and telehealth, making it easier for men to obtain treatment discreetly and affordably. With the continued growth of online shopping, it is becoming increasingly important to practise safe shopping when buying Cialis online. Consulting a doctor or pharmacist about options can help to navigate costs and ensure safe access.

Generic Cialis

Generic Cialis, also known as generic tadalafil, contains the same active ingredient as the branded version produced by Eli Lilly, but at a lower cost. This makes it an attractive option for men seeking treatment for ED. Approved by the FDA, after Cialis's patent expired in 2017 [13], generic tadalafil meets the same rigorous safety, efficacy and quality standards as the branded drug, as mandated by regulatory authorities.

Generic Cialis drugs, such as Tadalis-sx, Vidalista or Tadacip, contain the same active ingredient, tadalafil, which is a PDE5 inhibitor that enhances blood flow to the penis to facilitate erections during sexual stimulation. Clinical studies, such as those published in the Adult Urology, confirm that generic tadalafil is as effective as Cialis, with similar success rates (60–80% for improved erections) and duration of action (up to 36 hours) [8].

Men considering generic tadalafil should discuss this with their doctor or pharmacist to confirm that it is suitable for their health needs, and to explore cost-saving options such as patient assistance programmes or insurance coverage. Its affordability and accessibility make generic tadalafil a practical choice for effectively managing ED.

Cialis vs Other ED Treatments

Cialis is one of several PDE5 inhibitors used to treat ED, alongside Viagra, Levitra and Spedra. While all these medications work by enhancing blood flow to the penis to facilitate erections, each has unique characteristics that may suit different needs. The best choice depends on individual preferences, health conditions and medical advice. The table below compares Cialis with other PDE5 inhibitors based on clinical data and patient-reported outcomes:

Cialis vs. Viagra

Cialis lasts up to 36 hours, whereas the effects of Viagra (sildenafil) last 4–6 hours. Cialis offers greater spontaneity, while Viagra is better suited to planned encounters. Viagra typically takes effect in 30–60 minutes, which is slightly faster than Cialis (30–60 minutes, sometimes as early as 15 minutes), according to clinical trials. Cialis's daily low-dose option (2.5 mg or 5 mg) supports regular sexual activity, whereas Viagra is only taken as needed (more info).

Cialis vs. Levitra

Levitra (vardenafil) lasts 4–6 hours, which is shorter than Cialis's 36 hours. This makes Cialis preferable for those seeking extended flexibility. Both take effect in about 30–60 minutes, though Levitra may act slightly faster in some men, according to patient reports. Cialis is also approved for BPH, whereas Levitra is primarily approved for ED.

Cialis vs. Spedra

Spedra (avanafil) is the fastest acting, often becoming effective within 15–30 minutes compared to Cialis's 30–60 minutes. Spedra lasts 4–6 hours, which is significantly shorter than Cialis; therefore, Cialis is better for prolonged spontaneity. Spedra is a newer medication which is not as widely available as Cialis or its generic form, tadalafil, which impacts accessibility, according to pharmacy data.

While each medication has a similar efficacy rate, differences in onset, duration and dosing flexibility cater to varied lifestyles. For instance, Cialis's long duration and daily option suit men who prioritise flexibility, whereas Spedra's rapid onset appeals to individuals who want quick results. It is essential to consult a healthcare provider to select the most appropriate option, considering factors such as health conditions, medication interactions and personal preferences.

Key takeaways

Cialis is a reliable and flexible solution for men with ED, helping to restore confidence, intimacy and sexual potency. Its unique features, including an extended duration and dual benefits for ED and BPH, empower men to address their sexual health proactively. With affordable generic options widely available, Cialis makes effective treatment accessible. However, consulting a healthcare provider is still essential to ensure safe, personalised care. Taking this step enables men to overcome the challenges of ED and embrace a fulfilling, healthy future.

References

  1. A Daugan, P Grondin, C Ruault, A-Ch Le Monnier de Gouville, H Coste, J Kirilovsky, F Hyafil, R Labaudinière (Sep 2003), "The Discovery of Tadalafil:  A Novel and Highly Selective PDE5 Inhibitor.", Journal of Medicinal Chemistry, pubs.acs.org
  2. U.S. Food and Drug Administration (March 2004), "Drug Approval Package: Cialis (tadalafil) Tablets", accessdata.fda.gov
  3. European Medicines Agency (May 2024), "Summary of the European public assessment report (EPAR) for Cialis", ema.europa.eu
  4. J Calloway, L Fitzpatrick (Jul 2005), "Lilly ICOS' Cialis® (tadalafil) Reaches $1 Billion Global Sales Milestone", Eli Lilly and Company, investor.lilly.com
  5. ClinCalc DrugStats (2025), "Tadalafil; Drug Usage Statistics, United States, 2013 - 2022", ClinCalc, clincalc.com
  6. Wikipedia (2024), "PDE5 inhibitor", wikipedia.org
  7. R W Lewis, R Sadovsky, I Eardley, M O'Leary, A Seftel, W Ch Wang, W Shen, D J Walker, D G Wong, S Ahuja (Jul 2005), "The Efficacy of Tadalafil in Clinical Populations", The Journal of Sexual Medicine, academic.oup.com
  8. H Porst, H Padma-Nathan, F Giuliano, G Anglin, L Varanese, R Rosen (Jul 2003), "Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial", Adult Urology, goldjournal.net
  9. H Porst (Feb 2002), "IC351 (tadalafil, Cialis): update on clinical experience", International Journal of Impotence Research, nature.com
  10. H Porst, F Giuliano, S Glina, D Ralph, A R Casabé, A Elion-Mboussa, W Shen, J S Whitaker (Aug 2006), "Evaluation of the Efficacy and Safety of Once-a-Day Dosing of Tadalafil 5 mg and 10 mg in the Treatment of Erectile Dysfunction: Results of a Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial", European Urology, sciencedirect.com
  11. R Velurajah, O Brunckhorst, M Waqar, I McMullen, K Ahmed (Mar 2022), "Erectile dysfunction in patients with anxiety disorders: a systematic review", International Journal of Impotence Research, nature.com
  12. F Montorsi, B Verheyden, E Meuleman, K-P Jünemann, I Moncada, L Valiquette, A Casabé, C Pacheco, J Denne, J Knight, S Segal, V S Watkins (Mar 2004), "Long-term safety and tolerability of tadalafil in the treatment of erectile dysfunction", European Urology, sciencedirect.com
  13. K Richter (Jan 2020), "Tadalafil patent destroyed in further blow for ICOS and Eli Lilly", Juve Patent, juve-patent.com