Frequently asked questions.

Symptoms of BPH, such as needing to go frequently and urgently, can increase with age and often occur with erectile dysfunction (ED).

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CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke.

Do not take CIALIS if you take any medicines called "nitrates." Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.

• Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called "poppers" also contain nitrates, such as amyl nitrite and butyl nitrite.
• Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are nitrates. (See Who should not take CIALIS?)

Tell all of your healthcare providers that you take CIALIS. If you need emergency medical care for a heart problem, it is important for your healthcare provider to know when you last took CIALIS.

After taking a single tablet, some of the active ingredient of CIALIS remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.

Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. (See What are the possible side effects of CIALIS?)

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Do not take CIALIS if you:

• Take any medicines called "nitrates"
• Use recreational drugs called "poppers" like amyl nitrite and butyl nitrite. (See What is the most important information I should know about CIALIS?)
• Are allergic to CIALIS or ADCIRCA^® (tadalafil), or any of its ingredients. Symptoms of an allergic reaction may include:
  • Rash
  • Hives
  • Swelling of the lips, tongue, or throat
  • Difficulty breathing or swallowing

Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.

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CIALIS is not right for everyone. Only you and your healthcare provider can decide if CIALIS is right for you. Before taking CIALIS, tell your healthcare provider about all your medical problems, including if you:

• Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS if your healthcare provider has told you not to have sexual activity because of your health problems
• Have low blood pressure or have high blood pressure that is not controlled
• Have had a stroke
• Have liver problems
• Have kidney problems or require dialysis
• Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• Have ever had severe vision loss, including a condition called NAION
• Have stomach ulcers
• Have a bleeding problem
• Have a deformed penis shape or Peyronie's disease
• Have had an erection that lasted more than 4 hours
• Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

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Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. CIALIS and other medicines may affect each other. Always check with your healthcare provider before starting or stopping any medicines. Especially tell your healthcare provider if you take any of the following*:

• Medicines called nitrates. (See What is the most important information I should know about CIALIS?)
• Medicines called alpha-blockers. These include 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. If CIALIS is taken with certain alpha-blockers, your blood pressure could suddenly drop. You could get dizzy or faint
• Other medicines to treat high blood pressure (hypertension)
• Medicines called human immunodeficiency virus (HIV) protease inhibitors, such as ritonavir (Norvir^®) or lopinavir/ritonavir (Kaletra^®)
• Some types of oral antifungals such as ketoconazole (Nizoral^®) or itraconazole (Sporanox^®)
• Some types of antibiotics such as clarithromycin (Biaxin^®), telithromycin (Ketek^®), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine)
• Other medicines or treatments for ED
• CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Do not take both CIALIS and ADCIRCA. Do not take sildenafil citrate (Revatio^®) with CIALIS

*The brands listed are trademarks of their respective owners and are not trademarks of Eli Lilly and Company. The makers of these brands are not affiliated with and do not endorse Eli Lilly and Company or its products.

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The most common side effects of CIALIS are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Men who get back pain and muscle aches usually get them 12 to 24 hours after taking CIALIS. Back pain and muscle aches usually go away within 2 days. Call your healthcare provider if you get any side effect that bothers you or one that does not go away.

Uncommon side effects include:

• An erection that won't go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
• Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
• In rare instances, men taking phosphodiesterase 5, or PDE5, inhibitors (oral ED medicines, including CIALIS) reported a sudden decrease or loss of vision in one or both eyes. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS, and call a healthcare provider right away.
• Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS and contact a healthcare provider right away.

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

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CIALIS belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. PDE5 is an enzyme in the body that helps prevent blood vessels from relaxing and filling up with blood. This relaxation leads to increased blood flow. And increased blood flow to the penis is necessary for getting and maintaining an erection.

PDE5 enzymes are also found in the prostate and bladder. CIALIS inhibits PDE5 in these tissues as well, but the mechanism of how CIALIS 5 mg for daily use improves BPH symptoms is not completely understood.

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CIALIS 5 mg for daily use is the dosing option approved for the treatment of both ED and the signs and symptoms of BPH. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg. Do not take CIALIS more than 1 time each day.

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No. To properly treat the signs and symptoms of BPH with CIALIS, you need to take CIALIS once a day, every day. Only CIALIS 5 mg for daily use is approved to treat both ED and the signs and symptoms of BPH. Do not take CIALIS more than 1 time each day. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg. 36-hour CIALIS for use as needed is not approved to treat the signs and symptoms of BPH.

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If you're taking CIALIS 5 mg for daily use for both the treatment of ED and the signs and symptoms of BPH, it may take up to 4 to 5 days before CIALIS 5 mg for daily use may start to work for ED, or you may get results earlier. Cialis 5 mg for daily use can help improve the symptoms of BPH as early as 2 weeks after beginning treatment, although it may take as long as 4 weeks to see an improvement. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg. Do not take CIALIS more than 1 time each day.

When you start treatment, track and monitor your results and share the information with your healthcare provider. And keep in mind that after you take a single tablet, some of the active ingredient of CIALIS can remain in your body for more than 2 days. It can remain longer if you have problems with your kidneys or liver, or if you are taking certain other medications. Please see full Patient Information to learn more.

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If you miss a dose, take it when you remember. However, do not take CIALIS more than 1 time each day.

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The cost of a 1-month supply (30 days) of CIALIS for daily use (2.5 mg and 5 mg) should be about the same as 6 tablets of 36-hour CIALIS (5 mg, 10 mg, and 20 mg).* For patients who do not have prescription coverage, retail pharmacy prices may vary. As of December 2011, 30 tablets of CIALIS 5 mg, on average, cost $135.* However, this is just an estimate. Lilly does not control pharmacy retail prices. Check with your local pharmacy for actual retail prices. The cost of a CIALIS prescription varies by insurance plan and by pharmacy. Call your health plan provider for more information about your coverage for CIALIS.

CIALIS 5 mg for daily use is the dosing option approved for the treatment of both ED and the signs and symptoms of BPH. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg.

*Estimate is based on national out-of-pocket cost and average Rx size using SDI VOPA data; SDI's Vector One^®: Payer, December 2011.

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ED is a medical condition that happens when the normal process of getting an erection is interrupted. This can be caused by a lot of different things, such as diabetes, high cholesterol, stress, too much alcohol consumption, smoking, and other causes. Also, the signals that your brain sends to bring on an erection can be interrupted by nerve damage from a spinal cord injury, nervous system disease, or even some treatments for prostate cancer.

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It's true that as men get older, sexual function is likely to decrease and ED becomes more common. But simply getting older by itself does not lead to ED, nor is ED just a natural part of aging that men have to accept.

ED affects men of all ages. It's a real medical condition that affects approximately 18 million men in the United States, both young and old. If ED is a problem for you, it can be addressed, no matter your age.

More often than not, ED is caused by other health problems, such as heart disease, or diabetes, which are also more common as a man gets older. So, in addition to being a problem that can affect your sexual relationship, ED may also be a sign of other health conditions that your healthcare provider should know about.

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CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke.

Do not take CIALIS if you take any medicines called "nitrates." Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.

• Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called "poppers" also contain nitrates, such as amyl nitrite and butyl nitrite.
• Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are nitrates. (See Who should not take CIALIS?)

Tell all of your healthcare providers that you take CIALIS. If you need emergency medical care for a heart problem, it is important for your healthcare provider to know when you last took CIALIS.

After taking a single tablet, some of the active ingredient of CIALIS remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.

Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. (See What are the possible side effects of CIALIS?)

CLOSE

Do not take CIALIS if you:

• Take any medicines called "nitrates"
• Use recreational drugs called "poppers" like amyl nitrite and butyl nitrite. (See What is the most important information I should know about CIALIS?)
• Are allergic to CIALIS or ADCIRCA^® (tadalafil), or any of its ingredients. Symptoms of an allergic reaction may include:
  • Rash
  • Hives
  • Swelling of the lips, tongue, or throat
  • Difficulty breathing or swallowing

Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.

CLOSE

CIALIS is not right for everyone. Only you and your healthcare provider can decide if CIALIS is right for you. Before taking CIALIS, tell your healthcare provider about all your medical problems, including if you:

• Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS if your healthcare provider has told you not to have sexual activity because of your health problems
• Have low blood pressure or have high blood pressure that is not controlled
• Have had a stroke
• Have liver problems
• Have kidney problems or require dialysis
• Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• Have ever had severe vision loss, including a condition called NAION
• Have stomach ulcers
• Have a bleeding problem
• Have a deformed penis shape or Peyronie's disease
• Have had an erection that lasted more than 4 hours
• Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

CLOSE

Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. CIALIS and other medicines may affect each other. Always check with your healthcare provider before starting or stopping any medicines. Especially tell your healthcare provider if you take any of the following*:

• Medicines called nitrates (see What is the most important information I should know about CIALIS?)
• Medicines called alpha-blockers. These include 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. If CIALIS is taken with certain alpha-blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
• Other medicines to treat high blood pressure (hypertension)
• Medicines called human immunodeficiency virus (HIV) protease inhibitors, such as ritonavir (Norvir^®) or lopinavir/ritonavir (Kaletra^®)
• Some types of oral antifungals such as ketoconazole (Nizoral^®) or itraconazole (Sporanox^®)
• Some types of antibiotics such as clarithromycin (Biaxin^®), telithromycin (Ketek^®), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine)
• Other medicines or treatments for ED.
• CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Do not take both CIALIS and ADCIRCA. Do not take sildenafil citrate (Revatio^®) with CIALIS

*The brands listed are trademarks of their respective owners and are not trademarks of Eli Lilly and Company. The makers of these brands are not affiliated with and do not endorse Eli Lilly and Company or its products.

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The most common side effects of CIALIS are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Men who get back pain and muscle aches usually get them 12 to 24 hours after taking CIALIS. Back pain and muscle aches usually go away within 2 days. Call your healthcare provider if you get any side effect that bothers you or one that does not go away.

Uncommon side effects include:

• An erection that won't go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
• Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
• In rare instances, men taking phosphodiesterase 5, or PDE5, inhibitors (oral ED medicines, including CIALIS) reported a sudden decrease or loss of vision in one or both eyes. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS, and call a healthcare provider right away.
• Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS and contact a healthcare provider right away.

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

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Talking with your partner about ED may not be easy, but it can be helpful — for both of you. If you and your partner avoid the conversation, neither of you can know what the other is thinking and feeling. For many men, ED is a condition that is treatable.

You should be open and honest, as well as sensitive, about your partner's needs and questions. Remember to stick to the facts and try to think and talk about ED as the medical problem that it is. That way, you'll both gain a better understanding of what you're going through, and what to expect, as a couple.

You may want to reassure your partner that your ED is not her fault and that your condition could be caused by a medical issue.

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CIALIS is a prescription medicine that you take by mouth for the treatment of ED. When you get an erection, blood flows into your penis and is temporarily trapped there, creating pressure in the surrounding chambers that cause your penis to expand. When you have ED, this process is interrupted. CIALIS for daily use (2.5 mg and 5 mg) and 36-hour CIALIS (5 mg, 10 mg and 20 mg) may increase blood flow to your penis when you are sexually stimulated. CIALIS may improve the ability to get erections and maintain them until sexual intercourse is successfully completed. It may also improve the overall satisfaction with the hardness of erections. After sexual intercourse is completed, the erection should go away. But in the rare event of an erection lasting more than 4 hours, seek immediate medical help to avoid permanent damage. Please see full Patient Information and talk to your healthcare provider to learn more.

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CIALIS offers 2 different dosing options to treat ED. There's CIALIS for daily use (2.5 mg and 5 mg), a low-dose tablet you take once a day so you can attempt sex anytime between doses.* It may take up to 4 to 5 days before CIALIS for daily use may start to work for ED, or you may get results earlier. Your healthcare provider may start you on one dose and then adjust it, depending on how your body responds to the medicine. Do not take CIALIS for daily use more than 1 time each day.

Then there's 36-hour CIALIS (5 mg, 10 mg, and 20 mg), which you take as needed. With 36-hour CIALIS, 1 tablet can help some men be ready for sexual activity in as little as 30 minutes, and it may work for up to 36 hours.*^† Do not take 36-hour CIALIS more than 1 time each day.

If your healthcare provider decides that CIALIS is right for you, talk to him or her and your partner to help decide which option best fits your needs. If you are not satisfied, talk to your healthcare provider, who may recommend an adjustment to your CIALIS dosage. For more information about the 2 CIALIS options, click here.

*Individual results may vary. Not studied for multiple attempts per dose.

^†In clinical trials, 36-hour CIALIS started to work in 30 minutes for some men who took 20 mg of 36-hour CIALIS. When taken as needed, 36-hour CIALIS was shown to improve, up to 36 hours after dosing, the ability of men with ED to have a single successful intercourse attempt.

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If you're taking CIALIS for daily use (2.5 mg or 5 mg) for ED, it may take up to 4 to 5 days before CIALIS for daily use may start to work and you are able to have successful intercourse, or you may get results earlier. If after 4 or 5 days you have not experienced the results that you hoped for, talk to your healthcare provider, who may recommend an adjustment to your CIALIS dosage. CIALIS for daily use is a low-dose tablet. Do not take CIALIS for daily use more than 1 time each day.

36-hour CIALIS (5 mg, 10 mg, or 20 mg) may start to work in as little as 30 minutes in some men and may work for up to 36 hours.*^† It may take a few times to get the results you may want. Talk to your healthcare provider if you do not get the results you expect. Do not take 36-hour CIALIS more than 1 time each day.

When you start treatment, track and monitor your results and share the information with your healthcare provider. And keep in mind that after you take a single tablet, some of the active ingredient of CIALIS can remain in your body for more than 2 days. It can remain longer if you have problems with your kidneys or liver, or if you are taking certain other medications. Please see full Patient Information to learn more.

*Individual results may vary. Not studied for multiple attempts per dose.

^†In clinical trials, 36-hour CIALIS started to work in 30 minutes for some men who took 20 mg of 36-hour CIALIS. When taken as needed, 36-hour CIALIS was shown to improve, up to 36 hours after dosing, the ability of men with ED to have a single successful intercourse attempt.

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Do not take CIALIS for daily use and 36-hour CIALIS at the same time. If you are taking one of the CIALIS dosing options and would like to start taking the other one, discontinue use and talk to your healthcare provider. You should not take any other ED treatment while taking CIALIS. Do not take CIALIS more than 1 time each day.

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Do not split CIALIS for daily use tablets (2.5 mg and 5 mg) or 36-hour CIALIS tablets (5 mg, 10 mg, and 20 mg). CIALIS tablets are not scored down the middle, so you may not be able to break one exactly in half. If a CIALIS tablet is not split exactly in half, you may not receive an adequate dose or you may receive a larger dose than you need. If you do not get the proper dose, you may not get the results you are hoping for. If your healthcare provider thinks CIALIS is right for you, he or she will prescribe the recommended dose. Your healthcare provider may adjust your dose depending on how your body responds to the medicine. Do not take CIALIS for daily use more than 1 time each day.

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If you miss a dose, take it when you remember. However, do not take CIALIS more than 1 time each day.

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After your free trial, the cost of a 1-month supply (30 tablets) of CIALIS for daily use (2.5 mg and 5 mg) should be about the same as 6 tablets of 36-hour CIALIS (5 mg, 10 mg, and 20 mg) for use as needed. A nationwide analysis of out-of-pocket cost for patients without prescription coverage estimates that 30 tablets of CIALIS 5 mg, on average, cost $135 in December 2011.* However, this is just an estimate. Eli Lilly and Company, the maker of CIALIS, does not set or control the actual retail price at pharmacies.

Patients should check local pharmacies for actual retail prices, which may vary by pharmacy. Both national and regional managed care coverage has expanded for CIALIS for daily use, so be sure to contact your health plan's member services to find out if you're covered for a full month's prescription.

*Estimate is based on national out-of-pocket cost and average Rx size using SDI VOPA data; SDI's Vector One^®: Payer, December 2011.

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BPH, also known as an enlarged prostate, is a noncancerous condition in which the prostate becomes enlarged and may cause problems associated with urination. For more detailed information about what BPH is, click here.

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Symptoms of BPH, such as needing to urinate frequently and urgently, can increase with age and often occur with ED.

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CIALIS belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. PDE5 is an enzyme in the body that helps prevent blood vessels from relaxing and filling up with blood. This relaxation leads to increased blood flow. And increased blood flow to the penis is necessary for gettting and maintaining an erection.

PDE5 enzymes are also found in the prostate and bladder. CIALIS inhibits PDE5 in these tissues as well, but the mechanism of how CIALIS 5 mg for daily use improves BPH symptoms is not completely understood.

CLOSE

CIALIS 5 mg for daily use is the dosing option approved for the treatment of both ED and the signs and symptoms of BPH. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg. Do not take CIALIS more than 1 time each day.

CLOSE

No. To properly treat the signs and symptoms of BPH with CIALIS, you need to take CIALIS once a day, every day. Only CIALIS 5 mg for daily use is approved to treat both ED and the signs and symptoms of BPH. Do not take CIALIS more than 1 time each day. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg. 36-hour CIALIS for use as needed is not approved to treat the signs and symptoms of BPH.

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If you're taking CIALIS 5 mg for daily use for both the treatment of ED and the signs and symptoms of BPH, it may take up to 4 to 5 days before CIALIS 5 mg for daily use may start to work for ED, or you may get results earlier. For the signs and symptoms of BPH, you may see improvement as early as 2 weeks after beginning treatment, although it may take as long as 4 weeks before it may start to work. For the treatment of ED only, the recommended starting dose of CIALIS for daily use is 2.5 mg. Do not take CIALIS more than 1 time each day.

When you start treatment, track and monitor your results and share the information with your healthcare provider. And keep in mind that after you take a single tablet, some of the active ingredient of CIALIS can remain in your body for more than 2 days. It can remain longer if you have problems with your kidneys or liver, or if you are taking certain other medications. Please see full Patient Information to learn more.

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