Cialis 20mg: How it Compares to Other ED Treatments

Tadalafil, the active ingredient in the medication Cialis®, is one of the most effective and widely used options on the market for treating erectile dysfunction, or ED.

As with other erectile dysfunction medications, Cialis is available in a variety of dosages. One of the most common forms of Cialis is a 20mg tablet, which is designed for use when needed as a treatment for erectile dysfunction.

If you suffer from erectile dysfunction, using Cialis at a 20mg dosage may make it easier for you to get and maintain an erection. 

However, the 20mg dosage of Cialis isn’t the only way that you can take this medication, nor is it necessarily the best ED treatment option for everyone. 

Below, we’ve explained how Cialis 20mg works, as well as how it compares to other dosages of Cialis as a treatment for erectile dysfunction.

We’ve also discussed how Cialis 20mg compares to other FDA-approved ED medications, such as Viagra® (sildenafil), Levitra® (vardenafil) and Stendra® (avanafil).

How to Take Cialis 20mg

Before we go into detail on how to take Cialis for optimal results, let’s answer one very common question: How does Cialis work? 

At a simple level, Cialis works by increasing the amount of blood that can flow into the tissue in your penis when you receive sexual stimulation, such as before sexual activity.

Tadalafil, the active ingredient in Cialis, belongs to a class of medications that are referred to as PDE5 inhibitors. 

These medications work by inhibiting the action of the enzyme phosphodiesterase type 5, which is found in the smooth muscle tissue of your blood vessels. 

Phosphodiesterase type 5, or PDE5, regulates blood flow to the erectile tissue of your penis. By inhibiting PDE5, medications like Cialis allow extra blood to flow into your penis, improving your erectile function.

Erections, in case you weren’t aware, are all about blood flow. When you’re sexually stimulated, your nerves signal to bodies of tissue in your penis called the corpora cavernosa, which relax to allow blood to flow in and create pressure.

Cialis differs from other ED medications in several ways, the biggest of which is its long duration of action. 

How long does Cialis last? Compared to other ED medications, such as Viagra (sildenafil) and Levitra (vardenafil), both of which last just for a few hours each, a single dose of Cialis can last up to 36 hours.

Due to its ability to provide long-lasting relief from ED symptoms, Cialis has earned a reputation as the “weekend pill” for treating erectile dysfunction. 

In addition to treating ED, tadalafil, the active ingredient in Cialis, is also used to treat pulmonary hypertension, a form of elevated blood pressure that affects the blood vessels in the lungs, and benign prostatic hyperplasia (BPH).

Taking Cialis is easy. If you’re prescribed Cialis 20mg, you can take your medication around one hour before the time you plan to engage in sexual activity. 

This gives tadalafil, the active ingredient in each Cialis tablet, sufficient time to be absorbed into your bloodstream and start producing a noticeable effect. 

Because Cialis lasts for such a long period of time, a single dose of 20mg is typically enough to provide relief from erectile dysfunction well into the next day. This means that if you plan to have sex more than once a day, Cialis is a good choice. 

Cialis 20mg Benefits

Cialis offers several advantages as an ED medication, from its long-lasting effects to the ability to use it once a day. Common Cialis 20mg benefits include:

• You can have sex more than one time per day. Cialis’s long duration of action means it only needs to be taken once a day, even if you plan to have sex several times and like to have lasting relief from ED.

• It’s highly effective. According to clinical trials, a single 20mg dose of Cialis provides an improvement in erections in the majority of men with ED.

• Side effects are typically mild. Although side effects can occur with Cialis 20mg, many improve over time, while others may become less severe following a dose adjustment of your medication.

Cialis 20mg Side Effects

Like other ED medications, Cialis can cause side effects. Most side effects from Cialis are mild, although in rare cases, medications such as Cialis may cause more serious or bothersome side effects. 

Common side effects of Cialis include:

• Headaches. Headaches can occur with all ED medications, including Cialis. According to clinical study data, headaches were reported by 15 percent of men who took Cialis at a dosage of 20mg, making them the most commonly reported adverse effect.

• Indigestion and heartburn. Cialis and other medications for ED can cause indigestion, or heartburn. This issue occurred in 10 percent of men who took Cialis at a 20mg dose in clinical trials.

• Back and/or muscle pain. Cialis can cause back pain and/or myalgia, a form of muscle aches and muscle pain. Five to six percent of men who use Cialis at a dosage of 10mg to 20mg report experiencing this side effect.

• Flushing. Because of its effects on your blood vessels, Cialis may cause you to develop facial flushing. This side effect occurs in around three percent of men who use Cialis and can also occur with other medications used for the treatment of erectile dysfunction.

• Nasopharyngitis (cold symptoms). A small percentage of men who use Cialis develop cold-like symptoms, such as nasal congestion, or “stuffy nose.”

In rare cases, Cialis and other medications for ED may cause more serious side effects, such as dizziness, reduced blood pressure, hearing problems, loss of vision or chest pain. 

If you develop any severe or concerning side effects after taking Cialis, it’s important to talk with your healthcare provider as soon as you can. 

Cialis and other ED medications may also cause priapism, a form of painful, prolonged erection that can damage the tissue of your penis. This is a highly uncommon side effect with few case reports in medical literature.

Priapism is a serious medical emergency that, if left untreated, can cause damage to the tissue inside your penis. If you develop a persistent or painful erection after taking Cialis, it’s important to seek emergency medical attention as soon as you can. 

Our guide to priapism provides more information about this side effect, as well as what you can do if you think you’re affected.

Like other medications, Cialis can cause allergic reactions in a small percentage of people. You should seek medical help as soon as possible if you develop swelling of your face, tongue, lips, eyes or extremities, difficulty breathing or swallowing, or blistering or peeling of your skin.

Cialis Drug Interactions

Cialis can interact with other medications. Some medications, including those prescribed to treat heart disease or hypertension, can cause dangerous and potentially life-threatening side effects when used with Cialis or generic tadalafil.

If you’re prescribed Cialis, it’s important not to take it with nitrates or other heart medications. If taken together, these medications can produce a sudden decrease in blood pressure that could cause dizziness, fainting, or serious cardiovascular events such as heart attack or stroke.

These effects may also occur with recreational drugs that contain nitrates, such as amyl nitrate and butyl nitrite “poppers” used for sexual enhancement. 

To reduce your risk of experiencing a drug interaction, make sure to tell your healthcare provider about any medications you currently use or have recently used before taking Cialis. 

Cialis 20mg vs. Other Cialis Dosages

Cialis comes in oral tablet form and is available in several dosages, ranging from just 2.5mg per tablet to 5mg, 10mg and 20mg. The 20mg version of Cialis is currently the maximum dose that’s approved by the FDA for erectile dysfunction.

Some of these Cialis dosages are designed for use as needed (used only before sex), whereas others are designed for use every day. We’ve explained how each Cialis dosage differs in more detail below.

Cialis 10mg

The FDA recommends the 10mg version of Cialis as a starting dosage for use as needed as a treatment for erectile dysfunction. If you suffer from ED and want to use Cialis as needed, it’s likely that your healthcare provider will recommend this dosage.

Research shows that the 10mg dosage of Cialis works well for the majority of men affected by erectile dysfunction.

In clinical trials, 68 percent to 77 percent of men with erectile dysfunction who used Cialis at a 10mg dosage were able to have penetrative sex with their partner, compared to 46 percent to 55 percent of men who were given a non-therapeutic placebo.

As you may expect, Cialis 10mg has a moderately higher rate of side effects than lower doses of this medication, and a slightly lower rate of side effects than Cialis 20mg.

Cialis 20mg

Cialis is also available as a 20mg tablet. This version of Cialis is the strongest dosage that has been approved for use by the FDA and, just like the 10mg version of Cialis, is designed for use as needed before you have sex.

Your healthcare provider may prescribe the 20mg version of Cialis if you don’t get satisfactory results from the 10mg dosage.

Studies of Cialis 20mg have found that it’s typically more effective than lower-dose versions of Cialis.

In clinical trials, 76 percent to 85 percent of men with ED who were given this dosage of Cialis could successfully have penetrative sex with their partner, versus 68 to 77 percent of men who used Cialis at a 10mg dosage.

Cialis 20mg is slightly more likely to cause certain side effects, such as headache or dyspepsia (indigestion), than the 10mg dosage of Cialis. However, the increased risk of experiencing side effects is fairly small.

Even at the highest dosage of Cialis, side effects are still uncommon. In clinical trials, the most common side effect of Cialis, headache, was only reported by 15 percent of men who used the 20mg version of the medication.

Cialis 5mg

Cialis is available as a 5mg tablet. This version of Cialis can be taken daily (we’re explained this in more detail below) or as needed to treat erectile dysfunction.

Your healthcare provider may suggest using Cialis 5mg if you experience significant side effects from the 10 or 20mg dosages, or if they think that these dosages are more than needed in order to treat your erectile dysfunction.

Research shows that when used as needed, Cialis 5mg is more effective than a non-therapeutic placebo but less effective at treating ED than Cialis 10mg or 20mg.

It’s also slightly less likely to cause common ED medication side effects, such as headache and dyspepsia (indigestion).

Daily Cialis (Cialis 5mg and 2.5mg)

Cialis is also available as a daily-use medication at dosages of 5mg and 2.5mg. These versions of Cialis are designed to be taken daily at the same time, instead of as needed before you have sex.

Taking Cialis daily rather than as needed has several advantages, such as fewer common side effects and a simpler dosage schedule. It also means that you’ll be ready to have sex any time during the day, rather than just after taking your medication.

However, it also has some disadvantages, such as side effects that may be more persistent or bothersome. We’ve discussed these in more detail in our full guide to daily-use Cialis.

Cialis 20mg vs. Viagra (Sildenafil)

Cialis is often compared to other ED medications such as Viagra (sildenafil). As a treatment for erectile dysfunction, the 20mg dosage of Cialis offers several advantages compared to Viagra: 

• It’s longer-lasting. The effects of Cialis 20mg last for approximately 36 hours, making it a very long-lasting treatment for erectile dysfunction. In comparison, the effects of Viagra typically last for approximately four hours.
  Thanks to its longer duration of action, as-needed Cialis may be a better choice for you if you want to treat erectile dysfunction for the entire day with a single dose of medication.

• It’s less affected by food. Cialis is not affected by food, meaning you can take it before or after eating. This may be useful if you plan to take Cialis with dinner in order to have sex later in the nighttime.
  While it’s also okay to take Viagra with food, taking Viagra after a meal that contains lots of fat may affect the drug’s absorption and slow down its effects.

On the other hand, the 20mg dosage of Cialis also has a variety of disadvantages compared to Viagra:

• In certain circumstances, it might be too long-lasting. Cialis is famous for providing relief from ED for longer than other medications. However, if you only need to treat your ED symptoms for a night, the 36-hour effects of Cialis may be more than needed.

• It may cause longer-lasting side effects. Because of Cialis’s long half-life and duration of action, it can cause more persistent side effects than other ED medications. This may be an issue if you’re prone to side effects from PDE5 inhibitors.

Is 20mg Cialis equal to 100mg Viagra in terms of efficacy? 20mg is the maximum dose of Cialis and 100mg is the maximum dose of Viagra, meaning your healthcare provider may suggest that you use 100mg of Viagra if you’re prescribed Cialis and want to change medications.

Ultimately, Cialis and Viagra are different medications that treat the same condition. The biggest advantage of Cialis is its long duration of action, while the main advantage of Viagra is that it’s a great medication for use as needed for a single night of sex. 

Our Cialis vs. Viagra guide goes into more detail on the main advantages and disadvantages of both medications, from effectiveness to side effects, ease of use, safety and more.

Tadalafil 20mg vs. Other ED Medications

In addition to Cialis, other medications, such as Levitra (vardenafil) and Stendra (avanafil) can also treat erectile dysfunction. Like Viagra, these medications differ from the 20mg dosage of Cialis in several ways: 

• Levitra. Levitra typically lasts for slightly longer than Viagra, but is much shorter-acting than Cialis. This makes it a good alternative to Cialis if you’d like to use ED medication as needed, rather than once per 36 hours.
  Our more detailed Levitra vs. Cialis comparison provides more information on how these popular ED medications differ.

• Stendra. Stendra is a new medication for ED. It starts working in as little as 15 minutes, making it a much faster-acting medication than Cialis. On average, a dose of Stendra provides relief from ED for up to six hours.
  As a newer ED medication, Stendra has a lower risk of causing certain side effects than Cialis.

Is Cialis 20mg Right For You?

The 20mg dosage of Cialis is a good option if you want relief from erectile dysfunction that lasts for an entire day or longer, or if you’ve previously used Cialis at a 5mg or 10mg dose and didn’t experience satisfactory effects. 

However, it’s slightly more likely to produce side effects than the 10mg version of Cialis, which is why healthcare professionals typically prescribe Cialis at a lower dosage first.

We offer brand name Cialis and tadalafil online as part of our range of ED medications, following a consultation with a healthcare provider who will determine if a prescription is appropriate. 

We also offer a range of other ED medications, including Viagra, generic sildenafil and Stendra (avanafil). 

All of these medications are effective at treating ED, with each offering its own range of unique advantages and disadvantages.

Worried about ED? Our complete guide to erectile dysfunction explains everything you need to know about this common sexual performance issue, from the top causes of ED to your options for treating erectile dysfunction and enjoying a fulfilling, satisfying sex life. 

You can also learn more about the cost of using Cialis or generic tadalafil to treat ED in our full guide to Cialis pricing.