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Cialis Dosage Guide: What Is The Right Dosage?

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 8/12/2021

If you live with erectile dysfunction (ED), you've probably heard about the drug Cialis® and its potential for helping you get and maintain an erection. 

Cialis, which is also available as the generic medication tadalafil, has been proven effective at managing ED in men. 

But more than that, its long half-life allows for some flexibility in sexual intercourse that other ED medications don’t offer.

Cialis is available in four different doses that cover all of the bases. There are daily dosages of 2.5mg and 5 mg, which allow for spontaneous sexual activity. 

It’s also available in 10mg and 20mg dosages, which can be taken as-needed to treat ED and allow you to have sex when you want to. 

This dosage gives you the choice of taking Cialis just before sex, without having to use medication every day. 

Used as-needed, one dosage of Cialis can last for up to 36 hours, saving you the need to plan ahead like with shorter-acting medications such as sildenafil (the active ingredient in Viagra®), vardenafil (Levitra®) or avanafil (Stendra®).

But with all of these options to choose from, you’re probably wondering which dosage of Cialis might be right for you.

Let us help in making your decision easier. We’ll start at the beginning by explaining how Cialis works as a treatment for erectile dysfunction. 

Then, we’ll look at the dosages that are available to help you determine which is the best option for you.

What Is Cialis (Tadalafil) Used For?

Tadalafil, the active ingredient in Cialis, is used to treat a handful of different conditions. While it is best known as a treatment for erectile dysfunction, it’s also used to treat:

  • Benign prostatic hyperplasia (BPH, or enlarged prostate)

  • Pulmonary arterial hypertension (PAH)

We’ve discussed the different uses of Cialis below, as well as how the medication works to treat these conditions.

Cialis for Erectile Dysfunction

Cialis is best known as a treatment for erectile dysfunction. Like other ED medications, it works by inhibiting the effects of an enzyme called PDE5, which is responsible for controlling the flow of blood to your penis. 

Healthy erections are all about blood flow. When you feel sexually aroused, blood flows to your corpora cavernosa -- the soft, sponge-like erectile tissue that’s inside your penis -- causing it to become firm and enlarged.

Medications that reduce the effects of PDE5 are referred to as PDE5 inhibitors. By inhibiting the effects of PDE5, medications such as Cialis relax and expand the blood vessels near the penis and increase blood flow, allowing for easier, more reliable erections.

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Cialis for Benign Prostatic Hyperplasia (BPH)

Although Cialis is usually thought of as a medication for ED, it’s also used to treat several other conditions. 

One of these is benign prostatic hyperplasia -- a condition in which the prostate gland grows in size. BPH is also commonly referred to as benign prostate enlargement, or simply as enlarged prostate.

BPH is common in older men. Although it isn’t a cancerous form of growth, it can cause certain irritating symptoms, such as an increased need to urinate, dribbling at the end of urination and pain during urination or after ejaculation.

Cialis for Pulmonary Arterial Hypertension (PAH)

Tadalafil, the active ingredient in Cialis, is also used to treat pulmonary arterial hypertension, a form of pulmonary hypertension in which blood pressure increases in the arteries that transport blood from your heart to your lungs.

Pulmonary arterial hypertension can develop on its own or with other cardiovascular diseases, such as left heart disease (LHD), sickle cell disease (SCD) and its variants, chronic obstructive pulmonary disease (COPD) and conditions such as pulmonary embolism (PE).

Tadalafil and other PDE5 inhibitors treat PAH by dilating the arteries inside the lungs, reducing blood pressure and improving blood flow.

When it’s used to treat pulmonary arterial hypertension, tadalafil is usually sold under the brand name Adcirca®.

How Does Cialis Help You Last Longer in Bed?

A variety of different things can contribute to or cause erectile dysfunction, but many of the most common are physical health issues that affect blood flow. 

By dilating the blood vessels that supply blood to your penis, Cialis and similar medications help to promote firmer, healthier erections. 

This is important if you find it difficult to develop an erection, but it’s also important if you can get an erection, but often lose it during sex. 

ED can vary in severity. For some guys, it can mean a total inability to get an erection, even with sexual stimulation. 

For others, it might mean getting an erection but finding it difficult to maintain it during sex, or not being able to get an erection every time you want to have sex.

Because of its effects on blood flow to your penis, Cialis has a positive effect on your erections, as well as your general sexual function.

For example, some research has found that Cialis may help to increase ejaculation latency time (the amount of time that passes before reaching orgasm and ejaculating).

Dosages of Cialis

Since ED can vary in severity based on many different factors, right off the bat, you should know that there’s no uniform dosage of Cialis that will work for everyone. 

The most appropriate Cialis dose for you will depend on your needs, your healthcare provider's assessment and how well you respond to the medication. 

Cialis is available in two forms -- as a daily-use medication, and for use as-needed. Daily Cialis is available in dosages of 2.5mg and 5mg. 

If you’re prescribed Cialis for daily use, it’s important to take it at approximately the same time every day.

Taking Cialis every day is a good option if you’ve already responded well to PDE5 inhibitors, or if you have sex more than two times per week.

Most of the time, your healthcare provider will prescribe Cialis for daily use at a daily dosage of 2.5mg. 

This may be increased to 5mg if you don’t respond to the lower dosage, or if you need a more significant effect from the medication. 

Cialis is also available as-needed. This means that you take this medication whenever you plan to have sex within a day. 

When prescribed for as-needed use, Cialis is available in 5mg, 10mg and 20mg doses.

The recommended starting dose of Cialis for use as needed is 10mg. This may be increased to 20mg if you still find it difficult to get or maintain an erection at a 10mg dose, or reduced to 5mg if you develop side effects from Cialis.

Cialis is designed for use one time per day. Regardless of the Cialis dosage you’re prescribed, you should not take Cialis or other ED medication more than once per day.

Like other medications for ED, Cialis starts working quickly. In most cases, you’ll start to notice the effects of Cialis in 30 to 60 minutes. 

Cialis reaches its maximum concentration in your body approximately 30 minutes to six hours after use.

Cialis absorption is not affected by food, meaning you can take Cialis on its own or with a meal without affecting the amount of time it takes for the medication to start working.

Which Is Better: Daily Cialis or On-Demand Cialis?

Daily-use Cialis and on-demand Cialis both offer a few advantages and disadvantages, meaning there’s no “best” option for everyone. 

We’ve looked at the major benefits and drawbacks of each dosing option below. 

Advantages of Daily Cialis

Taking Cialis on a daily basis offers several advantages, from the convenience of a daily routine to the ability to have sex spontaneously, without having to worry about taking medication. 

Arguably the biggest advantage of taking a daily dose of Cialis is that the medication remains in effect all the time, meaning you’re always ready to have sex.

This means that you’ll be able to enjoy spontaneous sex without having to worry about carrying Cialis with you or waiting 30 to 60 minutes after taking your medication.

If you’re on vacation or just suddenly feel in the mood, the “always on” effects of daily Cialis can be a major upside. 

You're always on and ready to go, without any need to schedule sex around your medication.

Another advantage of daily-use Cialis is that you can take it at the same time every day, without any need to think about other factors.

This is great if you’re prone to forgetting your medication. Instead of having to think about when you’ll take Cialis, you can make your single dose part of your morning or evening routine. 

Because daily-use Cialis is typically taken at a 2.5mg or 5mg dosage, it may also be less likely to cause side effects than higher-dosage, as-needed Cialis. 

Disadvantages of Daily Cialis

Despite its advantages, taking a daily dose of Cialis also has a few minor downsides. The first of these is that because of the lower dosage, it often takes several days for daily-use Cialis to become fully effective. 

Before Cialis can reach a steady state in your system, you’ll need to have administered a daily dose of the drug over the course of five days.

Another potential disadvantage of daily-use Cialis is that the medication is always working. If you’re prone to side effects from Cialis, such as nasal congestion, headache or muscle pain, this could become an annoyance.

Advantages of On-Demand Doses of Cialis

Using Cialis on an as-needed basis offers several advantages. The first is that you gain more autonomy when it comes to treating ED. 

Instead of needing to take Cialis every day, you can tailor your usage based on when you plan to have sex.

This can be helpful if you only see your partner a few days per week and don’t need Cialis on certain days. 

The second advantage of as-needed Cialis is that there’s no need to wait several days for the medication to reach a steady-state in your body. 

Thanks to the higher dose, as-needed Cialis starts working quickly and typically reaches its peak concentration within two hours.

Finally, if you have sex infrequently, only taking Cialis when it’s needed could reduce the total amount you spend on ED treatments. 

Disadvantages of On-Demand Cialis

The main disadvantage of taking Cialis on demand is that you’ll need to plan ahead when you want to save sex. 

Since Cialis usually takes 30 to 60 minutes to start working, you’ll need to time your medication use to make sure it’s active when you spend time with your partner.

Because Cialis has a long half-life, it’s okay to take it several hours before you have sex. This makes timing as-needed Cialis much easier than with shorter-acting ED medications, such as sildenafil, vardenafil or Stendra®.

Another disadvantage of as-needed Cialis is the higher dosage. Although this isn’t an issue for everyone, if you’re prone to side effects, the higher dose of Cialis that’s used before sex might make certain side effects more intense and severe.

If you develop any side effects while using Cialis or other ED medications, it’s important to tell your healthcare provider. 

Both forms of Cialis are well tolerated and effective at treating ED. Ultimately, the best option depends on your needs, lifestyle and preferences. 

Our guide to daily-use Cialis goes into greater detail about how you can choose between daily and as-needed Cialis to treat ED.

Cialis Missed Dose Instructions

If you’re prescribed Cialis for daily use, it’s far from uncommon to sometimes forget to use your medication. 

If you forget to take Cialis, take the missed dose as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue using Cialis as normal. 

Do not take a double dose of Cialis or use this medication more than once per day.

What is The Maximum Dose of Cialis?

The maximum dose of Cialis for erectile dysfunction is 20mg per day when taken as needed, or 5mg when taken on a daily basis. 

For benign prostatic hyperplasia, Cialis should be taken one time per day at a fixed dose of 5mg.

Adcirca, a version of tadalafil used to treat pulmonary arterial hypertension, should be taken one time per day at a dose of 40mg.

Do not exceed the recommended dose of Cialis. If you’re prescribed Cialis and don’t notice any improvements at the dose you’re prescribed, make sure to consult with your healthcare provider before making any changes to your dosage or use of this medication. 

Side-Effects of Cialis

Cialis is a safe and effective medication for most people. However, like other medications, it can cause side effects. Common Cialis side effects and adverse reactions include:

  • Indigestion or heartburn

  • Headaches

  • Nausea

  • Diarrhea

  • Flushing

  • Coughing

  • Stuffy nose

  • Pain that affects the back, muscles, stomach and/or limbs

Although uncommon, Cialis can cause more severe side effects. If you develop any of the side effects listed below, contact your healthcare provider or seek emergency medical care as soon as possible:

  • Blurred vision

  • Sudden loss of vision

  • Sudden hearing loss

  • Ringing in the ears

  • Chest pains

  • Dizziness

  • Difficulty breathing or swallowing

  • Hives and/or skin rash

  • Blistering or peeling of the skin

  • Swelling that affects your face, throat, mouth, eyes or limbs

Some of these side effects may occur as a result of an allergic reaction to Cialis or ingredients used in this medication. 

Cialis usage may come with more serious side-effects, however. Instances of priapism, vision and hearing loss, hypotension and cardiovascular events are typically rare Cialis side effects, but have been linked to its active ingredient, tadalafil.

Cialis and other medications used to treat erectile dysfunction may interact with medications used to treat other medical conditions, including nitrates and other medications used to treat hypertension (high blood pressure).

Some recreational drugs, such as “poppers” that contain amyl nitrate or butyl nitrate, can also interact with Cialis and cause a sudden decrease in blood pressure.

Make sure to inform your healthcare provider about all medications you currently use or have recently used before taking Cialis.

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Using Cialis

Cialis is one of the most popular medications used in the treatment of erectile dysfunction, and for good reason. 

Not only is it effective at treating ED, but its long duration of action means that it only needs to be taken once a day to provide lasting effects. 

When it comes to using Cialis, there are two options: take a low dose on a daily basis, or take a slightly higher dose of Cialis as needed. 

If your sexual activity is predictable and limited to once or twice a week, taking Cialis as needed may be the best choice for you.

Alternatively, if you’re more sexually active and have sex multiple times a week, or if you prefer the convenience of being able to have sex when you want to, taking a daily dose of Cialis may offer more advantages for you. 

Whether you use it daily or on demand, Cialis is more than capable of improving your erections and helping you to enjoy an active, fulfilling and satisfying sex life. 

We offer brand name Cialis and generic tadalafil online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. 

Our range of erectile dysfunction medications also includes other options, such as sildenafil (the active ingredient in Viagra) and Stendra, a new, faster-acting ED treatment with a favorable side effect profile.

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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  4. Dhaliwal, A. & Gupta, M. (2021, June 25). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
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  6. Pulmonary Hypertension. (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/pulmonary-hypertension
  7. Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  8. Karabakan, M., Keskin, E., Akdemir, S. & Bozkurt, A. (2017, March-April). Effect of tadalafil 5mg daily treatment on the ejaculatory times, lower urinary tract symptoms and erectile function in patients with erectile dysfunction. International Brazilian Journal of Urology. 43 (2), 317–324. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433372/
  9. CIALIS (tadalafil) tablets, for oral use. (2011, October). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf
  10. Washington, S.L., 3rd & Shindel, A.W. (2010). A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy. Drug Design, Development and Therapy. 4, 159–171. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939761/
  11. ADCIRCA (tadalafil) tablets for oral administration. (2009, May). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/022332lbl.pdf

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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