Cialis not working anymore? Possible next moves

You’ve done the hard part—you’ve opened up to your healthcare provider about your erectile dysfunction (ED), and they’ve prescribed Cialis (tadalafil) to treat it. But now, Cialis isn’t working the way it did initially, or maybe it never worked well for you in the first place. What can you do? 

The good news is that there are many different safe and effective treatment options for ED, even if Cialis doesn’t work. Read on to learn about your options.  

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Sometimes, people find that tadalafil is not working as well as it did in the past for treating their erectile dysfunction. Here are some steps you can take to troubleshoot: 

• Keep in mind that Cialis (tadalafil) and other ED medications won’t give you an automatic erection. You need to be aroused for the medication to work.

• Be sure to wait at least 30 minutes after taking the medication before trying to get an erection. 

• Consider trying the medication on your own first (without a partner) to see how it affects you. 

• If you’re taking any new medications, these might affect how well Cialis works for you. Talk to your healthcare provider about any changes. 

• Cialis can be prescribed as a daily medication (typically at a lower dose of 2.5 or 5 mg per day) or on an as-needed basis (usually at a higher dosage of 10 or 20 mg taken about an hour before you want to have sex). If you’re on the lower daily dose, it can take about five days for the medication to build up in your system, so give it a little time. If you’re using Cialis as needed before you want to have sex, experts recommend trying it 3-5 times (but never more than once in any 24-hour period) because it can take a few tries for the medication to start working.

• Higher-dose tadalafil gummies, which contain 7 mg and are designed for daily use, are available to make it easier to get an erection. You can speak with a Ro-affiliated healthcare provider to see if treatment with Daily Rise Gummies is right for you.

If you’ve tried these methods and the medication still isn’t working for you, it’s a good idea to reach out to your healthcare provider. They can evaluate whether you might be a candidate for combined treatment with tadalafil and sildenafil (Viagra) or whether a different dosage might be appropriate for you. Combined treatment with a medication like Ro Sparks, which contains both sildenafil and tadalafil in a single dissolving drop, is one option for effective treatment without the wait time associated with other options. Remember, it’s crucial that your healthcare provider make any medication changes to ensure that you’re taking the most safe and effective dose for you.

If tadalafil and other drugs like it are not working for you, your healthcare provider may suggest other treatment options, including: 

• Testosterone therapy

• Injections into the penis (intracavernosal injections or ICI)

• Vacuum restriction devices

• Intraurethral therapy (a pill that’s inserted into the opening of the penis)

• Penile implants (surgically placed implants that allow you to control their erection manually)

• Penile vascular surgery (usually reserved for younger men with a history of trauma to the penis)

• Lifestyle changes—Eat a healthy diet, exercise, stop smoking, decrease stress, and avoid drugs and alcohol. 

• Natural remedies like DHEA, ginseng, L-arginine, L-carnitine, and yohimbe

Emotional issues can also affect ED. Things like relationship conflicts, stress, depression, or anxiety can all contribute to ED, and there’s often a vicious cycle with ED, where the inability to perform in the bedroom can create performance anxiety, which then makes ED worse. Help from a mental health professional can be an essential part of overcoming ED for some people. 

ED can also signify an underlying medical condition, such as heart disease, high blood pressure, or diabetes, so it’s important to speak with your healthcare provider early. In the case of diabetes, for example, people often don’t know they have it, and ED may be the first sign. In addition, ED in people with diabetes is notoriously more difficult to treat, and getting treatment for diabetes can actually help with the ED.

If you’ve tried Cialis and it’s not working, don’t stress. Several treatment options exist for improving erectile dysfunction. Talk to your healthcare provider about your options. Don’t give up if one treatment doesn’t work—there are other choices, and your provider can help you find the one that is right for you.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

April 29, 2024

Written by

Chimene Richa, MD

Fact checked by

Yael Cooperman MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.