cialis
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.00 | $40.05 (0%) | 🛒 Add to cart |
| 20 | $2.75 | $80.10 $55.07 (31%) | 🛒 Add to cart |
| 30 | $2.34 | $120.15 $70.09 (42%) | 🛒 Add to cart |
| 60 | $1.84 | $240.30 $110.14 (54%) | 🛒 Add to cart |
| 90 | $1.78 | $360.45 $160.20 (56%) | 🛒 Add to cart |
| 120 | $1.59 | $480.60 $190.24 (60%) | 🛒 Add to cart |
| 180 | $1.39 | $720.89 $250.31 (65%) | 🛒 Add to cart |
| 270 | $1.22 | $1081.34 $330.41 (69%) | 🛒 Add to cart |
| 360 | $1.11
Best per pill | $1441.79 $400.50 (72%) | 🛒 Add to cart |
| Product dosage: 2.5mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.50 | $45.06 (0%) | 🛒 Add to cart |
| 60 | $1.33 | $90.11 $80.10 (11%) | 🛒 Add to cart |
| 90 | $1.22 | $135.17 $110.14 (19%) | 🛒 Add to cart |
| 120 | $1.17 | $180.22 $140.17 (22%) | 🛒 Add to cart |
| 180 | $0.89 | $270.33 $160.20 (41%) | 🛒 Add to cart |
| 270 | $0.78 | $405.50 $210.26 (48%) | 🛒 Add to cart |
| 360 | $0.68
Best per pill | $540.67 $245.30 (55%) | 🛒 Add to cart |
| Product dosage: 20mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.51 | $45.06 $45.06 (0%) | 🛒 Add to cart |
| 20 | $3.25 | $90.11 $65.08 (28%) | 🛒 Add to cart |
| 30 | $2.84 | $135.17 $85.11 (37%) | 🛒 Add to cart |
| 60 | $2.50 | $270.33 $150.19 (44%) | 🛒 Add to cart |
| 90 | $2.22 | $405.50 $200.25 (51%) | 🛒 Add to cart |
| 120 | $2.09 | $540.67 $250.31 (54%) | 🛒 Add to cart |
| 180 | $1.67 | $811.00 $300.37 (63%) | 🛒 Add to cart |
| 270 | $1.41 | $1216.51 $380.47 (69%) | 🛒 Add to cart |
| 360 | $1.31
Best per pill | $1622.01 $470.58 (71%) | 🛒 Add to cart |
| Product dosage: 5mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 20 | $2.25 | $45.06 $45.06 (0%) | 🛒 Add to cart |
| 30 | $2.00 | $67.58 $60.07 (11%) | 🛒 Add to cart |
| 60 | $1.50 | $135.17 $90.11 (33%) | 🛒 Add to cart |
| 90 | $1.45 | $202.75 $130.16 (36%) | 🛒 Add to cart |
| 120 | $1.25 | $270.33 $150.19 (44%) | 🛒 Add to cart |
| 180 | $1.11 | $405.50 $200.25 (51%) | 🛒 Add to cart |
| 270 | $0.96 | $608.25 $260.32 (57%) | 🛒 Add to cart |
| 360 | $0.88
Best per pill | $811.00 $315.39 (61%) | 🛒 Add to cart |
Synonyms | |||
Similar products
Cialis, known generically as tadalafil, is a phosphodiesterase type 5 (PDE5) inhibitor primarily prescribed for the management of erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). It works by relaxing smooth muscles and increasing blood flow to specific areas of the body, offering a longer duration of action compared to similar medications. This profile will explore its composition, mechanism, clinical applications, and practical considerations based on current evidence and real-world use.
Cialis: Effective Management for Erectile Dysfunction and BPH - Evidence-Based Review
1. Introduction: What is Cialis? Its Role in Modern Medicine
Cialis is the brand name for tadalafil, a prescription medication classified as a phosphodiesterase type 5 inhibitor. What is Cialis used for? Primarily, it addresses erectile dysfunction and symptoms of benign prostatic hyperplasia, either separately or concurrently when both conditions coexist. Since its approval, Cialis has become significant in urology and sexual medicine due to its unique pharmacokinetics—notably its extended half-life of approximately 17.5 hours, which allows for both on-demand and once-daily dosing regimens. This flexibility provides distinct advantages in treatment personalization, making it a cornerstone in managing these common conditions, especially in aging male populations.
2. Key Components and Bioavailability of Cialis
The active pharmaceutical ingredient in Cialis is tadalafil. It’s formulated as film-coated tablets in strengths of 2.5 mg, 5 mg, 10 mg, and 20 mg. Unlike some supplements or combination products, Cialis does not contain additional active components; its efficacy stems solely from tadalafil. The bioavailability of tadalafil is about 36% to 41% following oral administration, with peak plasma concentrations reached within 2 hours under fasting conditions. High-fat meals can delay time to peak concentration but don’t significantly reduce overall absorption—something we consider when advising patients on timing. The tablet formulation ensures consistent release, and no special delivery systems are needed to enhance absorption, which simplifies patient use compared to some other agents that require careful administration around meals.
3. Mechanism of Action of Cialis: Scientific Substantiation
How does Cialis work? Tadalafil selectively inhibits phosphodiesterase type 5 (PDE5), an enzyme that breaks down cyclic guanosine monophosphate (cGMP). During sexual stimulation, nitric oxide (NO) is released, activating guanylate cyclase, which increases cGMP levels. Elevated cGMP causes relaxation of smooth muscle in the corpus cavernosum of the penis and vasodilation of penile arteries, resulting in increased blood flow and erection. For BPH, the same mechanism relaxes smooth muscle in the prostate and bladder neck, improving urinary flow. The key differentiator is Cialis’s longer half-life, which sustains this inhibition longer than sildenafil or vardenafil. Think of it as a sustained-release effect—it doesn’t just work for a few hours; it provides a therapeutic window that can last up to 36 hours, which many patients find less intrusive to spontaneity.
4. Indications for Use: What is Cialis Effective For?
Cialis for Erectile Dysfunction
Cialis is indicated for the treatment of erectile dysfunction of various etiologies—vascular, neurogenic, psychogenic, or mixed. Clinical trials demonstrate significant improvement in erectile function scores and successful intercourse attempts. It’s effective in diverse populations, including men with diabetes, hypertension, and spinal cord injury, though individual response can vary.
Cialis for Benign Prostatic Hyperplasia
For BPH, Cialis relieves lower urinary tract symptoms such as urgency, frequency, nocturia, weak stream, and incomplete emptying. It doesn’t reduce prostate size but improves symptoms through smooth muscle relaxation in the prostate and bladder, enhancing urinary flow and reducing bother.
Cialis for Concurrent ED and BPH
Many older men present with both conditions. The once-daily 5 mg dose is approved for treating both ED and BPH simultaneously, addressing two common issues with a single agent, which simplifies regimens and improves adherence.
Off-Label and Investigational Uses
Some evidence supports off-label use for pulmonary arterial hypertension (though not FDA-approved for this in the U.S.), altitude sickness prevention, and Raynaud’s phenomenon, but these are not primary indications and require careful risk-benefit assessment.
5. Instructions for Use: Dosage and Course of Administration
Dosing depends on the indication and patient factors. For erectile dysfunction, the recommended starting dose for on-demand use is 10 mg taken at least 30 minutes before sexual activity, which may be increased to 20 mg or decreased to 5 mg based on efficacy and tolerability. For daily use, 2.5 mg or 5 mg is taken once daily without regard to timing of sexual activity. For BPH or concurrent ED/BPH, the dose is 5 mg once daily. It can be taken with or without food.
| Indication | Dosage | Frequency | Timing |
|---|---|---|---|
| ED (on-demand) | 10 mg (range 5-20 mg) | As needed | 30-60 min before activity |
| ED (daily) | 2.5 mg or 5 mg | Once daily | Anytime, consistent |
| BPH | 5 mg | Once daily | Anytime, consistent |
| ED and BPH | 5 mg | Once daily | Anytime, consistent |
The course of administration is typically long-term for chronic conditions. Patients should be reassessed periodically to determine ongoing need and tolerability. Side effects are generally dose-related and may include headache, dyspepsia, back pain, myalgia, flushing, and nasal congestion, which often diminish with continued use.
6. Contraindications and Drug Interactions with Cialis
Cialis is contraindicated in patients using any form of organic nitrates (e.g., nitroglycerin, isosorbide) or guanylate cyclase stimulators like riociguat, due to the risk of severe hypotension. It’s also contraindicated in those with hypersensitivity to tadalafil or any component, and in men with cardiac conditions for whom sexual activity is not advised (e.g., unstable angina, recent myocardial infarction).
Important drug interactions include alpha-blockers (e.g., doxazosin, tamsulosin)—concomitant use can cause hypotension, so careful dosing and monitoring are needed. Potent CYP3A4 inhibitors like ketoconazole, ritonavir, or clarithromycin increase tadalafil exposure, requiring dose reduction (e.g., maximum 10 mg every 72 hours with strong inhibitors). Is Cialis safe during pregnancy? Not applicable, as it’s not indicated for women; safety in pregnant or breastfeeding women is not established.
7. Clinical Studies and Evidence Base for Cialis
The efficacy of Cialis is supported by numerous randomized controlled trials and meta-analyses. For ED, studies like the Integrated Data Analysis of 11 randomized trials showed 67-80% of men improved erections vs 29-35% on placebo. For BPH, the tadalafil 5 mg once daily demonstrated significant improvement in International Prostate Symptom Score (IPSS) and quality of life in 12-week and 52-week trials. Long-term extension studies up to 4 years show sustained efficacy and safety. Real-world evidence aligns with clinical trials, confirming its role in diverse populations, including difficult-to-treat cases like post-prostatectomy ED. Physician reviews consistently note high patient satisfaction, particularly with the daily dosing option for its “always ready” effect and dual benefit in ED/BPH.
8. Comparing Cialis with Similar Products and Choosing a Quality Product
When comparing Cialis with similar PDE5 inhibitors, key differences emerge. Sildenafil (Viagra) has a shorter duration (4-6 hours) and more food interactions. Vardenafil (Levitra) is similar to sildenafil in duration. Cialis offers the longest window of efficacy (up to 36 hours), which many patients prefer for spontaneity. Which Cialis is better—on-demand or daily? It depends on frequency of sexual activity and symptom pattern; daily dosing provides continuous coverage and is better for frequent activity or BPH.
Choosing a quality product means ensuring it’s obtained with a valid prescription from licensed pharmacies to avoid counterfeit products, which may contain incorrect doses or harmful substances. Generic tadalafil is bioequivalent to brand Cialis and often more cost-effective, but should be sourced from reputable manufacturers.
9. Frequently Asked Questions (FAQ) about Cialis
What is the recommended course of Cialis to achieve results?
For on-demand use, effects begin within 30-60 minutes and can last up to 36 hours. For daily dosing, steady state is reached in about 5 days, with continuous therapeutic effect.
Can Cialis be combined with blood pressure medications?
Yes, but with caution. Cialis can cause small decreases in blood pressure. With alpha-blockers, separate dosing by several hours or use the lowest effective dose under medical supervision.
Is Cialis safe for men with heart conditions?
In stable, well-managed cardiovascular disease, yes, but not if sexual activity is not recommended or if using nitrates. A cardiovascular assessment is advised before initiation.
How does Cialis differ from Viagra?
Main differences are duration (Cialis up to 36 hours vs Viagra 4-6 hours) and food effect (Cialis unaffected, Viagra delayed by high-fat meals).
Can Cialis be taken daily long-term?
Yes, studies support long-term use with periodic monitoring for efficacy and adverse effects.
10. Conclusion: Validity of Cialis Use in Clinical Practice
Cialis represents a well-validated option for erectile dysfunction and benign prostatic hyperplasia, supported by robust clinical evidence and extensive real-world experience. Its prolonged duration of action and flexible dosing regimens offer advantages in patient-centered care. The risk-benefit profile is favorable for appropriate candidates, with most adverse effects being mild and transient. For men with ED, BPH, or both, Cialis provides an effective, convenient treatment that can significantly improve quality of life when used under medical guidance.
I remember when we first started using tadalafil in our clinic—we were skeptical about the 36-hour claim, thinking it was just marketing. But then I had this patient, Mark, a 58-year-old with hypertension and mild BPH who’d failed on sildenafil due to timing issues. He took 10 mg Cialis on a Friday afternoon, and on Sunday morning, he still had a functional response. He came back and said, “Doc, I finally feel normal again.” That case changed my perspective.
Our team had disagreements initially—some urologists worried the long half-life would mean more side effects, but in practice, the incidence wasn’t higher than with shorter-acting agents. We did have a learning curve with dosing in older men on multiple antihypertensives; one 72-year-old on amlodipine and doxazosin had some dizziness with 10 mg, so we dropped him to 5 mg daily and it worked fine. Another surprise was how many men with BPH reported improved sexual function even when that wasn’t their primary complaint—almost an unexpected bonus.
Long-term, I’ve followed patients on Cialis for over 5 years. David, now 65, with diabetes and BPH, has been on 5 mg daily for both conditions. His IPSS score dropped from 18 to 8, and his IIEF-5 improved from 12 to 22. He says it’s “just part of his routine, like his morning coffee.” The data matches the anecdotes—consistent efficacy, good safety. We’ve had few dropouts due to side effects, mostly myalgia or back pain that didn’t resolve with continued use. Overall, it’s proven to be a reliable option in our armamentarium, especially for those valuing spontaneity or dealing with both urinary and sexual symptoms.