Is Cialis available over the counter?

If you’ve heard of Cialis®, you probably know it’s a popular choice for treating erectile dysfunction (ED). Since its effects can last up to 36 hours, some have nicknamed it the “weekend pill.” But what’s most important is that it is an FDA-approved medication that helps people get and maintain erections, making it a popular medication for people experiencing erectile dysfunction. 

But here’s the big question: Can you walk into a pharmacy and buy Cialis over the counter?

The short answer is no–you’ll need a prescription. Fortunately, there are other convenient ways to get ED medication that don’t involve a trip to the doctor’s office.

If you’ve been wondering how to get Cialis safely and effectively, this guide covers everything you need to know.

Cialis is not available over-the-counter (OTC), and you cannot get Cialis without a doctor’s prescription. A licensed healthcare provider, such as a doctor, nurse practitioner, or physician assistant, must prescribe Cialis or its generic version, tadalafil.

Despite some early discussions about making it an OTC medication, it remains prescription-only due to concerns about safety, potential misuse, and the need for proper medical oversight.

Why isn’t Cialis available OTC?

When Cialis’s patent expired in 2018, there was some hope that it might become available over the counter. Pharmaceutical company Sanofi even acquired rights to explore OTC approval. But years later, Cialis remains a prescription-only medication and there are some major reasons why.  

Here are a couple reasons why:

• Hidden health issues: ED is often linked to more serious medical issues like heart disease, diabetes, or anxiety. Skipping a medical evaluation could delay treatment for these conditions.

• Dangerous interactions: Certain medications and substances, like nitrates and poppers, can cause life-threatening reactions when mixed with Cialis. By requiring a prescription, healthcare providers can adequately explain the possible interactions with patients before they start Cialis.  

These factors have kept ED drugs like Viagra and Cialis firmly in the prescription-only category. Currently, there are no plans to make Cialis or its generic version available over-the-counter in the U.S.

The only erectile dysfunction treatment that you get OTC is Eroxon, a gel that is designed for the treatment of erectile dysfunction in people aged 22 years and over.

What is Cialis used for?

Cialis, or tadalafil, is part of a group of medications called PDE5 inhibitors, which can treat ED by improving blood flow to the penis. 

Here are a few key points about its use:

• It can be tailored to your health needs: Cialis comes in different doses, and your healthcare provider will determine the right one for you based on your overall health and any medications you’re taking.

• It’s prescribed for other conditions too: Besides ED, Cialis is also FDA-approved to treat benign prostatic hyperplasia (BPH), a condition that causes an enlarged prostate and difficulty urinating. Some men use it for both conditions.

• There are various dosage options: Cialis can be taken as needed before sexual activity, or daily. Cialis comes in smaller doses than Viagra, another popular ED medication, so you can take it daily if a provider recommends it. Your healthcare provider is best equipped to help you choose which option would be best for you.

Common side effects of Cialis

Cialis is generally safe when used as prescribed, but like most medications, it can come with potential side effects. Some of the more common ones are:

• Headaches

• Indigestion

• Back pain

• Muscle aches

• Nasal congestion

• Facial flushing

These side effects are usually mild and temporary, but it’s important to consult your healthcare provider if they persist or worsen.

In addition to that, your healthcare provider will need to know if you have low blood pressure, bleeding problems, or a heart condition, such as angina or a history of heart attack. These factors help determine whether Cialis is safe for you and what dosage would work best.

Will Cialis ever be available without a prescription?

As stated earlier, the idea has been floated, but it hasn’t happened yet. Back in 2018, there were discussions about making Cialis available without a prescription, but those plans never moved forward. Sanofi still holds the rights to explore OTC approval, so it’s possible we could see it on pharmacy shelves someday—but not anytime soon.

For now, if Cialis feels like an option you want to consider, getting a prescription is straightforward. Whether it’s the brand-name version or tadalafil, the generic, a licensed healthcare provider can help you decide if it’s a good fit, and in this next section, we’ll guide you through the process.

Both tadalafil and Cialis require a prescription to make sure you’re taking it safely. But getting a prescription doesn’t have to be complicated or uncomfortable.

Visit your primary care provider

Your primary care provider can be your first stop for ED concerns. They’re trained to handle a wide range of health issues, including sexual health, so don’t hesitate to bring it up.

When you visit, your provider will likely:

• Ask about your symptoms, such as trouble getting or keeping an erection.

• Review your medical history and lifestyle to rule out underlying causes like heart disease or diabetes.

• Discuss the potential risks and benefits of Cialis and other ED treatments.

If Cialis seems like a good fit, they will write you a prescription. If Cialis isn’t the best fit for you or your lifestyle, they may recommend alternative options, including other oral medications or lifestyle changes.

And if you’re worried about feeling awkward, remember that healthcare providers hear about these kinds of problems all the time. ED is incredibly common. Research shows that it affects up to 50% of men between the ages of 40 and 70, so this isn’t uncharted territory for them.

Meet with a urologist

For some people, talking to a specialist can feel more comfortable than discussing ED with a long-time primary care provider that you interact with often. If you’re dealing with ED and want to see an expert––preferably one who doesn’t already know you—a urologist can help (though you may need a referral from your PCP to see one). 

Urologists are experts in everything from the urinary tract to the penis, prostate, and testicles. They are used to handling ED cases every day. A urologist can also help address underlying causes such as hormonal imbalances or physical conditions like Peyronie’s disease.

Additionally, they’ll be able to recommend advanced treatments, like penis pumps, injections, or cock rings that aren’t typically offered by general healthcare providers.

Try an online medical consultation

If you’d rather skip the waiting room altogether, online healthcare services make getting a Cialis prescription more straightforward than ever. With an online consultation, you can:

• Fill out a questionnaire about your symptoms and medical history.

• Speak to a licensed healthcare provider via video or chat from the comfort of your home.

• Receive your Cialis prescription and have it delivered discreetly to your door.

This option is great for saving time and avoiding in-person conversations you might find uncomfortable. Many platforms even offer affordable generic versions of Cialis, like tadalafil, which can be significantly cheaper.

Ro makes it easy to access genuine Cialis by connecting you with licensed healthcare providers who can evaluate your needs and prescribe the right treatment. Here’s how the process works:

Step 1. Complete an online health assessment

Start by filling out Ro’s secure online visit questionnaire. This evaluation includes detailed questions about your medical history, current medications, and erectile dysfunction symptoms. It’s designed to take about 20 minutes and ensures the provider has all the information needed to recommend the right treatment.

Step 2. Review by a licensed healthcare provider

Within 24 hours, a licensed healthcare provider will review your assessment. They’ll evaluate your information, consider your preferences, and determine if Cialis or an alternative ED medication is appropriate. If more details are needed, they may reach out with follow-up questions.

Step 3. Receive your prescription

If prescribed, your medication is prepared by Ro and shipped in discreet packaging to your doorstep. Ro dispenses medications manufactured by FDA-regulated pharmaceutical companies, ensuring you receive authentic Cialis with accurate active ingredients and no harmful additives.

Step 4. Begin your treatment

Start your treatment as directed by your provider. Ro supports you throughout the process with unlimited free follow-ups. If you need adjustments to your dosage or want to discuss your progress, Ro’s healthcare team is available to ensure your treatment delivers the best possible results.

With Ro, you’re guaranteed a safe, trustworthy source for ED medication. We connect you with licensed providers and ensure you receive medication that meets strict quality and safety standards.

Ro offers a range of options for treating erectile dysfunction, designed to meet different needs and preferences. Whether you want a trusted brand, an affordable generic, or a fast-acting alternative, there are easy ways to access the right treatment for you.

• Brand-name Cialis: Known for its long-lasting effects, it allows flexibility in timing, and stays active for up to 36 hours. It comes with a higher price tag.

• Generic tadalafil: Ro also offers generic tadalafil, the active ingredient in Cialis, as an affordable and effective alternative to brand-name Cialis. Tadalafil is the active ingredient in both Cialis and generic of Cialis.

• Daily Rise Gummies: These daily gummies provide consistent low doses of tadalafil, keeping the medication in your system so you’re always ready for sex without needing to plan ahead.

• Ro Sparks: This 2-in-1 treatment combines sildenafil (55 mg) with tadalafil (22 mg) in a tablet that dissolves under your tongue for faster absorption. It helps you get an erection in as little as 15 minutes and stays active for up to 36 hours. Ro Sparks is available for $12 per dose with a monthly subscription plan.

If you are 18 or older, a provider can prescribe Cialis if it’s appropriate for you.

When you hear about ED, you probably think of it as an issue for older men. But that’s not the whole story: ED doesn’t have an age limit. While it’s more common as you age, men in their 20s and 30s can experience it too—and it’s nothing to be ashamed of.

Research suggests that the prevalence of ED in people aged 40 or younger is as high as 30%. ED can happen for various reasons that aren’t tied to age. Here are just some of the possible reasons:

• Type 2 diabetes

• High blood pressure

• Different kinds of injuries to the penis, spinal cord, or lower abdomen

• Depression or anxiety

• Some medications such as antidepressants 

In addition to that, there are other habits or lifestyle factors that might cause ED to get worse. This could be smoking, heavy drinking, some types of recreational drugs, being overweight, or not getting enough physical activity.

All this to say––it doesn’t matter how old or young you are, you could still end up dealing with ED. The good news is that in most cases, ED is treatable and Cialis is one possible treatment option. Tadalafil, its active ingredient, has been shown to help people of all ages. 

If you’re currently coping with ED, don’t let your age hold you back from talking to a healthcare provider who can help you figure out the cause of your ED and find a treatment that works for you.

One of the main reasons you can’t get Cialis or tadalafil OTC is that the medication may interact with other substances. Here are some of the drugs that Cialis can interact with:  

• Nitrates (e.g., Nitroglycerin): Nitrates are often prescribed for chest pain or heart conditions, and combining them with Cialis can lead to a drop in blood pressure.

• Alpha-Blockers (for blood pressure or prostate issues): If you’re on alpha-blockers, which help relax blood vessels, using Cialis can increase the risk of low blood pressure. For ED, you can combine these medications safely if you’re stable on your alpha-blocker and start Cialis at the lowest dose.

• CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir): Medications that inhibit an enzyme called CYP3A4 can slow down how your body processes Cialis. This increases the risk of side effects. If you’re taking these inhibitors, such as antifungal or antiviral drugs, your healthcare provider may lower your Cialis dose.

Always discuss your current medications, supplements, and habits with your healthcare provider to help avoid complications.

If you’re looking for something you can buy without a prescription, you won’t find Cialis or Viagra or tadalafil OTC in the U.S. However, there are some natural aphrodisiacs and herbal supplements that claim to support healthy erections.

While these supplements might sound appealing, it’s important to set realistic expectations before heading to your local store to try to treat your ED on your own. While no medication or supplement is guaranteed to be effective for everyone, non-prescription options lack the rigorous testing and oversight that FDA-approved drugs like Cialis or Viagra undergo.

This means their effectiveness and safety can vary widely. Products that claim to be “natural” or “herbal” may not list all their ingredients, making it difficult to know what you’re actually consuming.

In some cases, over-the-counter alternatives have been found to contain hidden ingredients. For example, the FDA identified supplements like Ginseng Power 5000, which was marketed as a natural sexual enhancement product, as containing undeclared tadalafil. This can be dangerous, because you don’t know how much you are consuming which can lead to unsafe doses and unwanted side effects.

Some supplements that have been studied for their potential to improve erectile function include:

• Korean red ginseng: There is some research that suggests that this traditional herb may help improve erectile dysfunction in some men, but results vary, and more studies are needed.

• Horny goat weed: This herb contains icariin, a compound that works similarly to PDE5 inhibitors (the class of drugs that includes Cialis). However, its effects haven’t been tested properly in humans, so its reliability is unknown.

• Yohimbe/yohimbine: While this supplement may alleviate ED symptoms for some, research is limited, and safety information is inadequately documented.

• L-arginine: This is an amino acid that increases nitric oxide, which is crucial for erections. Some smaller studies suggest it might be helpful for ED, but the evidence isn’t conclusive.

That said, caution is key when considering over-the-counter products for ED, especially pills marketed online, at gas stations, or in convenience stores. In fact, erectile dysfunction medications are some of the most counterfeited drugs worldwide. These counterfeit pills have been found to contain harmful substances like printer ink, talcum powder, or even unregulated drugs.

If you’ve been searching for generic Cialis without a doctor’s prescription, remember that only a healthcare provider can ensure it’s safe and right for you.

If you’re wondering how to get Cialis, the best approach is to consult a healthcare provider who can guide you through the process and provide a prescription if it’s suitable.

The good news is that getting a prescription is easier than ever, whether through your primary care provider, a specialist, or a quick online consultation.

Although over-the-counter alternatives might seem tempting, they don’t offer the same proven results as FDA-approved medications like Cialis. If you’re hesitant or unsure where to start, reaching out to a healthcare provider is the first step. They’ll guide you through the process, help identify the best treatment, and ensure it’s safe and right for you.

Remember that ED is often treatable, and medications like Cialis can help you enjoy sex again.

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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.

Editorial Guidelines | Medical Review Process

Current version

December 06, 2024

Written by

Chimene Richa, MD

Fact checked by

Raagini Yedidi, MD

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About the medical reviewer

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.