The weekend pill
Cialis has been licensed in the UK for over a decade. It was the second erectile dysfunction (ED) prescription medication of its type to receive a UK license, after Viagra (sildenafil). Its prolonged duration of action and the option to take a low dose daily tablet have led to Cialis becoming increasingly popular and being more widely prescribed.
The patent for Cialis expired in the UK on 14 November 2017, allowing other drug manufacturers to legally make and sell generic Cialis (marketed as tadalafil). Generic medicines are medically identical to branded originals and are usually much lower cost.
Daily versus Cialis '36 hours'
Most men take Cialis as and when they need it, usually 10mg or 20mg, which is effective for up to 36 hours.
Men who need erectile dysfunction treatment two or more times a week should consider taking a regular low dose Cialis tablet daily. Cialis 2.5mg or 5mg tablets taken every day will provide continuous erectile dysfunction treatment, without peaks and troughs.
What does it do?
Cialis contains tadalafil which is known medically as a PDE5 inhibitor. Tadalafil inhibits the PDE5 enzyme which is involved in regulating blood flow in the penis during erections. Sexual stimulation is required before the medication will work and without it Cialis will have no effect. Cialis augments and supports sexual performance and relationships.
Cialis can also be used to treat benign prostatic hyperplasia (enlarged prostate) symptoms.
Why do men get erectile dysfunction?
A range of factors contribute to erectile dysfunction, including lifestyle choices, mental state, chronic disease, and injuries and operations. Emotional problems, such as stress and performance anxiety, can have an impact on both erectile performance and sexual desire. Occasional treatment with a PDE5 inhibitor such as Cialis can be effective in breaking a cycle of anxiety and failure. Lifestyle factors, such as smoking, non-prescription drug use, excessive drinking and even obesity can have an effect. Erectile dysfunction is sometimes a symptom of underlying health problems such as diabetes, atherosclerosis and heart disease, amongst others.
Men suffering from erectile dysfunction should inform their GP who will undertake an assessment, possibly perform tests, and provide advice.
Cialis benefits from having a long duration of action. Viagra remains active for about 4 hours, Levitra for 4-5 hours and Cialis for 36 hours – hence its familiar name 'The Weekend Pill'. Erections will not be continuous during 36 hours after taking Cialis, occurring only at times of arousal during those 36 hours.
Viagra, Sildenafil, Levitra, and Spedra are alternative tablet treatments for erectile dysfunction and are also available to buy in various strengths and pack sizes after completing the same medical consultation.
Taking Cialis for the first time
There are four strengths of Cialis – 2.5mg, 5mg, 10mg and 20mg. The lower doses of 2.5mg and 5mg are primarily for regular daily use, although Cialis 5mg strength can be taken on an as required basis by men who respond well to one-off lower doses.
The usual starting dose is 10mg taken at least 30 minutes before sexual activity. If this dose is highly effective, subsequent doses could be reduced to 5mg on a trial basis. If repeated trials of a 10mg dose prove ineffective, the dose can be increased to 20mg.
There is no benefit in taking a higher dose than is needed. Repeated trials of treatment at one dose are recommended before changing to higher or lower strength tablets.
2.5mg or 5mg daily tablet for continuous erectile dysfunction treatment.
Recommended starting dose for most men taking Cialis for first time.
High strength dose as required for when 10mg is insufficient.
Does it work every time?
Response to treatment is usually predictable and consistent. On most occasions, if Cialis has worked before, it will work again.
Some causes of erectile dysfunction, such as physical injuries or nerve damage, are more resistant to tablet treatments and may require other therapies, such as injections or penile implants.
Erectile dysfunction may require specialist treatment apart from tablets. Some men, whose erectile dysfunction has psychological causes, may benefit from counselling.
All men who are troubled by erectile dysfunction, which can be a distressing problem, should consult a doctor for a full assessment and advice.
Side effects of Cialis
Most men taking Cialis do not experience significant side effects. A full list of the most frequent side effects can be found in the manufacturer's patient information leaflet supplied with Cialis tablets (links below).
Some men experience a bluish or yellowish tinge to their vision after taking Cialis. This is not dangerous and fades after a few hours time. This is a possible side effect of all ED drugs (PDE5 inhibitors).
Other common side effects (affecting 1%-10%) include headache, back pain, muscle aches, pain in the arms or legs, nasal congestion, facial flushing, and indigestion.
On very rare occasions ED treatment produces prolonged and painful erections, in a condition known as priapism. Priapism is a medical emergency with the potential on rare occasions for irreversible injury to the penis. If an erection lasts for more than 4 hours, medical attention should be sought immediately.
When not to take Cialis
During an assessment on the Dr Fox web site, men are required to complete an erectile dysfunction questionnaire. This determines if Cialis is suitable. Men should not take Cialis without further assessment from their GP if any of the following apply:.
- men at risk of priapism, e.g. if you have sickle cell anaemia
- men using other erectile dysfunction medications
- men with a penile implant
- men who have been told to avoid sexual activity
Men with the following conditions should not use Alprostadil:.