How Often Can You Take Tadalafil (Cialis)?

Tadalafil is one of the more popular and well know erectile dysfunction medications (after Viagra), and you may recognise the brand name of it; Cialis. It was not long ago when little was known of erectile physiology, and adequate treatment was still “someday” away. Prior to the turn of the century, the pharmacologic treatment options for ED were cumbersome and invasive, limited to intracavernosal injections or intraurethral pellets. Everything changed when oral phosphodiesterase type 5 (PDE5) inhibitors became available, completely revolutionizing the treatment of ED of all severities and etiologies. Pfizer introduced the first PDE5 inhibitor, sildenafil (Viagra®; Pfizer, New York, NY, USA), in March of 1998, and over the past years, the new oral pharmacologic therapy together with an unbridled acceptance and newfound candor by the general public has not only dramatically increased the awareness and prevalence of ED but also made treatment of the disease simple and effective. Once one of the most frustrating and refractory diseases for the urologic specialist, ED is now enthusiastically discussed and treated in the primary care setting. (1)  In November 2017 the patent on the popular Erectile Dysfunction (ED) medication Cialis, came to an end. This means a none branded, or generic version of the medication, known as Tadalafil, is now available to those suffering from ED symptoms, at a lower price.

 

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Does Cialis work the same way as Viagra?

Cialis is the brand name for tadalafil and Viagra is the brand name for sildenafil. Both belong to a class of medicines known as phosphodiesterase type 5 (PDE5) inhibitors. PDE5 inhibitors work only in the presence of sexual stimulation, as they rely on the natural release of nitric oxide (NO), a chemical only released during sexual arousal. NO, in turn, activates other substances to relax the smooth muscle inside the penis to allow the inflow of blood and an erection to occur. PDE5 inhibitors enhance the effect of NO. Cialis has an advantage over Viagra in that it lasts a lot longer for up to 36 hours compared with 4-5 hours for Viagra. Also, Viagra could

take up to an hour to work whereas Cialis takes about half that time. The onset of action of tadalafil may occur in as early as 15 minutes of dosing, although successful erections occur in fewer than 40% of men at this time point.

 

Is there any difference between Tadalafil and its branded version Cialis?

No, not at all. They are exactly thTadalafil_8TAB 20MGe same medication in the same quantities, it’s just the packaging that is different. There is no difference in quality or effectiveness.

 

Can women take Tadalafil?

The short answer is no. There has been no research that has been done to determine how safe it is for women to take Cialis and the effect it would have.

 

How does tadalafil work?

As mentioned, Tadalafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. The penis is one of the areas where this enzyme works.

Erectile dysfunction is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. When a man is sexually stimulated, his body’s normal response is to increase blood flow to his penis to produce an erection. By controlling the enzyme, tadalafil helps to maintain an erection by increasing blood flow to the penis. Without physical action to the penis, such as that occurring during sexual intercourse, tadalafil will not work to cause an erection. Studies suggest that ED is a common disorder in men, affecting up to 52% of men between the age of 40 and 70 years.

 

Does age play a role in ED?

Age alone does not lead to ED. ED can be treated no matter your age (CIALIS is only for men aged 18 or older). ED is often caused by other health problems that your doctor should know about, like heart disease or diabetes—which are also more common with age.

There can be many reasons for ED, most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about. If it happens more often, it may be caused by physical or emotional problems.

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:

  • Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
  • See your doctor for regular checkups and medical screening tests.
  • Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
  • Exercise regularly.
  • Take steps to reduce stress.
  • Get help for anxiety, depression or other mental health concerns.

 

How is Tadalafil taken?

Tadalafil is unique in the fact that it is available in two formulations in the branded version; Cialis for daily use and Cialis for use as needed

Cialis/Tadalafil for daily use (2.5 mg)

  • Take Cialis daily
  • You can attempt sex anytime between doses
  • No need to plan around a pill
  • With a 2.5 mg or 5 mg tablet once a day, you may be able to have successful intercourse in as early as 4 to 5 days
  • Do not take more than one time each day

Cialis/Tadalafil for use as needed (10 mg, 20 mg)

  • Take Cialis when you need it
  • Cialis 20 mg can last for up to 36 hours
  • A 20 mg dose works in as little as 30 minutes in some men
  • Do not take more than one time each day. (11)

Recommended starting doses of tadalafil are 10 mg for on-demand dosing and 2.5 mg for once-daily dosing, and these doses can then be titrated up or down according to the efficacy and tolerability.

 

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Cialis & Tadalafil (As Needed)

£16.98£260.00

Cialis works in a similar way to Viagra and is quicker acting and lasts longer. It can be taken when needed, 30 minutes before intercourse.

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Product Description

About Cialis

At least one in ten men has trouble getting an erection at some time. Cialis helps men to get and maintain an erection when sexually stimulated and/or excited. The medicine relaxes the blood vessels in the penis which results in more blood flowing to the penis. It reduces the action of the natural chemical in your body that makes erections go away.

How to take it?

You should take Cialis at least 30 minutes before intercourse. Cialis remains effective for 36 hours, meaning it will be easier to keep and maintain an erection when you are sexually excited. It doesn’t matter if you take this medicine with or without food; food has no impact on its effectiveness.

This medicine will only work when you’re sexually excited. You won’t get an erection just by taking Cialis.

What dose should I take?

The recommended starting dose for Cialis is 10mg tablets. If this dose is not effective you can try 20mg tablets. A maximum of one tablet should be taken in 24 hours, however it’s not recommended to take either the 10mg or 20mg tablet every day.

For patients who anticipate sexual activity at least twice weekly, the 5mg “daily” Cialis dose is more appropriate.

Patient Information Leaflet

Always read the patient information leaflet before commencing treatment. The Patient Information leaflets can be found here for 10mg and 20mg dosages.

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How often can you take Tadalafil? Can I take the needed dose every day?

No, it is recommended that

you wait for 36 hours between doses as it takes this long for the effects to wear off. Taking more than the recommended dose can possibly increase the risk of side effects as well as adverse reactions. If you suspect a drug overdose, you should contact your healthcare provider or seek emergency medical attention right away.

 

Will Cialis make me last longer?

Although it can be a common assumption that this will be the case, it actually isn’t. The medication facilitates the normal process of reaching and maintaining an erection but will not alter the duration in any way.

 

Are there any side effects?

As with all medications, there is a likelihood you may experience side effects, a full list of them can be found in the patient information leaflet and our pharmacists will be happy to answer any questions you may have. The common or very common side effects are back pain, dyspepsia, flushing, headache, myalgia, nausea and vomiting. Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by themselves within 48 hours. Uncommon ones are hypertension and tachycardia. The lower dose daily tablets have a lower incidence of side effects than the higher dose as needed tablets.

 

How do I decide whether the daily tablets or as needed tablets will be most suitable for me?

If you are likely to have sex three or more times a week or are in a long-term relationship, the daily dose may be the best option for you. Many patients and their partners dislike the necessity of on-demand treatment for ED, citing a desire for greater spontaneity with sexual interactions.

If you feel you don’t need ED medication every time or you have sex less regularly then the as needed dose may be the best option. The 20mg dose can be effective for up to 36 hours after its taken so is popularly known as the ‘The Weekender’. So if it is taken on Friday evening it could be effective until Sund

ay morning. Whereas the 5mg once daily dose is generally effective for up to 24 hours hence the requirement to take it daily for uninterrupted effectiveness. Lilly, the manufacturers of Cialis released their findings on the levels of the medication in the blood (and hence effect) over time;

It should be noted that efficiency of Cialis does not decrease even after long-term use. There are many men who use it regularly for a long time and it works well each time. So, a regular Cialis dosage does not usually require for a dosage increase.

 

Is there any reason I can’t take Tadalafil?

The first major contraindication to tadalafil’s use is a known hypersensitivity to the medication or any other ingredients used to make the pill. What hypersensitivity is referring to is an allergy-like reaction to the medication. What could a hypersensitivity reaction to tadalafil look like? Well, there’s

more than one possibility but it could manifest itself as a fever with a very painful rash and blisters, something known as Stevens-Johnson syndrome.

Another important contraindication to tadalafil is the concurrent use of medications known as nitrates or guanylate cyclase stimulators. Nitrates, like nitroglycerin, are medications that help treat things like angina, which is chest pain stemming

from a problem with the heart. Guanylate cyclase stimulators, like riociguat, can be used to treat high blood pressure in the lungs. Since all three, tadalafil, nitrates, and guanylate cyclase stimulators cause drops in blood pressure independently,

using two or more at the same time can lead to dangerously low blood pressure.

Will food or drink have an effect?

Food Drink and ViagraIt can be taken with or without food, in general food has little effect as demonstrated by a study. In the definitive food-effect study, 18 subjects received a single 20-mg Tadalafil dose in the fasted state, and on a separate occasion following a high-fat, high-calorie breakfast. The absence of a food effect was declared. However, it is important to be careful with grapefruit. It is recommended that you do not eat or drink grapefruit juice with tadalafil. This is because there is a chemical in grapefruit juice which can increase the amount of tadalafil in your bloodstream. This could make side-effects more likely.

Do not drink excessive amounts of alcohol when taking tadalafil. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increase your heart rate, or lower your blood pressure. (19) So one or two units of

alcohol are usually ok.

 

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References

  1.  Tadalafil in the treatment of erectile dysfunction, Robert M Coward and Culley C Carson
  2. Cialis (tadalafil) [Package Insert] Eli Lilly and Company 12/2015 https://www.drugs.com/pro/cialis.html
  3. Wright PJ. Comparison of Phosphodiesterase Type 5 (PDE5) Inhibitors. Int J Clin Pract. 2006;60(8):967-975. http://www.medscape.com/viewarticle/542736_4
  4. Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses.
  5. Brock GB, McMahon CG, Chen KK, Costigan T, Shen W, Watkins V, Anglin G, Whitaker S
  6. J Urol. 2002 Oct; 168(4 Pt 1):1332-6.
    1. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial., Porst H, Padma-Nathan H, Giuliano F, Anglin G, Varanese L, Rosen R, 2003 Jul; 62(1):121-5; discussion 125-6.
    2. PubMed Health, Tadalafil (by mouth), https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0012283/?report=details
  7. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study, Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB, J Urol. 1994 Jan; 151(1):54-61.
  8. https://www.cialis.com/common-questions-about-cialis.html
  9. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
  10. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
  11. https://www.cialis.com/cialis-for-ed-and-bph.html
  12. A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy Samuel L Washington, III1 and Alan W Shindel2
  13. Lilly Cialis, Full Prescribing Information https://pi.lilly.com/us/cialis-pi.pdf
  14. https://study.com/academy/lesson/tadalafil-drug-interactions-contraindications.html
  15. Tadalafil pharmacokinetics in healthy subjects, S Thomas Forgue, Beverley E Patterson,1 Alun W Bedding,2 Christopher D Payne, Diane L Phillips, Rebecca E Wrishko, and Malcolm I Mitchell
  16. https://patient.info/medicine/tadalafil-for-erectile-dysfunction-or-enlarged-prostate-cialis
  17. Mayo Clinic, Tadalafil (oral route). https://www.mayoclinic.org/drugs-supplements/tadalafil-oral-route/precautions/drg-20067204

 

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