erectile dysfunction / cialis

Cialis / generic Cialis

Tadalafil

Tadalafil is the generic form of the brand Cialis®. Both medications work similarly in the body.

Cialis® is a type of medication known as a PDE5 inhibitor that is used to treat erectile dysfunction and benign prostatic hyperplasia. It comes in several different doses and can be taken either as-needed or daily for erectile dysfunction.

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Transparent manufacturing

Cialis manufactured by Eli Lilly in Puerto Rico.

For erectile dysfunction, Cialis® should be taken at least 30-60 minutes before sex and its effects last 24-36 hours. Some people report that Cialis® works best when taken at least 2 hours before sex.

Serious side effects include an erection lasting more than 4 hours, sudden vision loss in one or both eyes, and sudden hearing decrease or loss. If these occur, seek medical attention immediately.

Talk to your doctor or nurse practitioner about your medical conditions and your medications before taking Cialis®. Do not take Cialis® if you are allergic to its ingredients or if you are already taking nitrates (such as nitroglycerin), street drugs called “poppers” (such as amyl nitrate, amyl nitrite, butyl nitrate), or guanylate cyclase stimulators (such as riociguat).

What is Cialis?

Cialis® is a drug that is used to treat erectile dysfunction (ED). It comes in four doses, 2.5 mg, 5 mg, 10 mg, and 20 mg. Cialis® can be taken as needed in any of the four doses. The 2.5 mg and 5 mg doses are also approved for daily use for ED. Cialis® in the 2.5 mg and 5 mg doses is also FDA-approved for men suffering from urinary symptoms due to benign prostatic hyperplasia (BPH) with or without ED. Physicians on the Roman platform do not currently treat BPH. If you feel you need Cialis for the treatment of BPH, please seek in-person care. For as needed dosing, the 10 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Cialis® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may lead the doctor or nurse practitioner to recommend one drug over the other based on your treatment goals.

What is tadalafil?

Tadalafil is the chemical name of the active ingredient in Cialis®. Cialis® was originally patented and sold by Eli Lilly. It is FDA-approved to treat ED and urinary symptoms due to BPH. After the patent expired in 2018, the FDA gave permission to other drug companies to manufacture a generic version of Cialis®. The FDA requires generic drugs to be bioequivalent to the brand name version. This means that they act the same way in the body and are expected to produce the same effects as the original brand name drug. Generic drugs are generally much cheaper than the original brand name drug, and most drugs prescribed in the US are generic.

Does Roman offer genuine Cialis?

Roman offers branded Cialis® and its generic, tadalafil, to treat ED. They are both FDA-approved to treat ED. They can be taken as needed (from 2.5 mg to 20 mg) or daily (in the 2.5 mg and 5 mg doses) to treat ED.

How does Cialis work?

In order to understand how Cialis® works to treat ED, it's important to first understand the basics of how erections work. Erotic stimulation (by physical touch, erotic thoughts, smells, etc.) causes the local tissues to release nitric oxide (NO), which increases the amount of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscles on the sides of the penis, the corpora cavernosa, to relax allowing blood to rush into the penis. At the same time veins that drain blood from the penis get compressed causing the increased blood to be trapped in the penis causing an erection. An enzyme called phosphodiesterase-5 breaks down cGMP leading the penis to return to its flaccid state. PDE5i, like Cialis®, block this enzyme leading to higher levels of cGMP and improving the ability to obtain and maintain an erection.

What is daily Cialis?

In addition to as needed dosing, Cialis® is also approved for daily use in the 2.5 mg and 5 mg doses. This creates a steady amount of medicine in the blood and completely eliminates the need to plan for sex. With daily Cialis®, treatment for ED becomes part of your daily routine. Most men who are eligible for ED treatment can take daily Cialis® with certain exceptions, including airline pilots, air traffic controllers, and people taking certain medicines (e.g., some HIV medicines, certain antibiotics and antifungals). You should speak with your doctor or nurse practitioner to determine if daily Cialis is an appropriate treatment option for you.

What should you know before taking Cialis

Contraindications

Who should not take Cialis® or generic Cialis®?

Do not take Cialis® or generic Cialis® if you:

  • take medicines called nitrates (such as nitroglycerin)
  • use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
  • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
  • are allergic to Cialis® or any of the ingredients in Cialis®. See the end of this section for a complete list of ingredients in Cialis®.

What should I tell my healthcare provider before taking Cialis® or generic Cialis®?

To make sure Cialis® is safe for you, tell your healthcare provider if you have any of the following before you take Cialis® or generic Cialis®:

  • Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • Have pulmonary hypertension
  • Have had a stroke
  • Have low blood pressure, or high blood pressure that is not controlled
  • Have a deformed penis shape
  • Have had an erection that lasted for more than 4 hours
  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • Have ever had severe vision loss, including an eye problem called NAION
  • Have bleeding problems
  • Have or have had stomach or intestinal ulcers
  • Have liver problems
  • Have kidney problems or are having kidney dialysis
  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Cialis® and generic Cialis® may affect the way other medicines work, and other medicines may affect the way Cialis® and generic Cialis® works, causing side effects.

Drug interactions

Tell your healthcare provider if you take any of the following because these drugs interact with Cialis® and generic Cialis®:

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® or generic VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • Other medicines or treatments for ED
  • Adcirca® (tadalafil) is used to treat a rare disease called pulmonary arterial hypertension (PAH) and has the same active ingredient as Cialis®. Cialis® and generic Cialis® should not be used with Adcirca® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Revatio® [sildenafil citrate])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Cialis® side effects

What are the possible side effects of Cialis® and generic Cialis®?

Cialis® and generic Cialis® can cause serious side effects. Rarely reported side effects include:

  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Cialis® and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop takingCialis® or generic Cialis® and contact a doctor right away.

The most common side effects of Viagra® and generic Cialis® are:

  • headache
  • flushing
  • upset stomach
  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
  • stuffy or runny nose
  • muscle pain
  • nausea
  • dizziness
  • rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Cialis® . Most, but not all, of these men had heart problems before taking Cialis® . It is not known if Cialis® caused these problems.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of Cialis® and generic Cialis® . For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What happens if I overdose?

Taking more than the recommended amount of Cialis® or generic Cialis® greatly increases your risk of side effects, including severe ones that can be dangerous, such as severe low blood pressure or an erection that won't go away even after 4 or more hours (priapism). Never take more than the amount prescribed to you by your doctor or nurse practitioner. If you have any severe side effects after taking more than the recommended amount, or even after taking the amount of medicine prescribed to you, seek out emergency medical attention immediately.

Important safety information