Cialis overdose: how much Cialis is too much?

Cialis (tadalafil) is a popular medication used for erectile dysfunction (ED). It can also be used to treat benign prostatic hyperplasia (BPH). No matter the reason for treatment, it’s important only to take the amount you're prescribed. Cialis overdose (taking too much of the medication) is possible. 

There are a few different dosages of Cialis that you might be prescribed, ranging from lower doses, which are typically prescribed for daily use, to higher doses that are usually prescribed on an as-needed basis. 

Read on to learn more about tadalafil overdose (the active ingredient in Cialis) and how to avoid it.

Yes, it’s possible to have a Cialis overdose, though it may not be what you think. 

By definition, an “overdose” is when you take more than the recommended amount of a medicine or drug. It can cause serious, harmful symptoms — though not every overdose leads to severe symptoms. 

It’s possible to take too much Cialis, but true overdose cases are rare. And most don’t cause the kind of life-threatening symptoms typically associated with other overdoses. Still, exceeding the prescribed dose can increase the risk of side effects and should always be avoided. 

The FDA-approved drug label for Cialis indicates that healthy individuals have received as much as 500 mg of tadalafil as a single dose, and others have received multiple daily doses of up to 100 mg. (For comparison, the typical tadalafil dosage for ED is 2.5 mg–5 mg when used daily or 5 mg–20 mg when used as-needed.)

In these individuals, side effects were similar to those observed at lower doses of the medication. However, additional information, such as how many people this actually applied to, is not available, and findings may not be generalizable for everyone. 

In general, you should never increase your Cialis dose without consulting your healthcare provider first. Taking too much can raise the risk of complications and side effects, and these risks can vary from person to person.

Side effects tend to be more likely in those with certain conditions, such as heart disease or abnormal blood pressure. However, even if you have no other healthcare issues, you should still only take your medication exactly as prescribed. 

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If you take too much Cialis, you may experience common side effects, such as headaches, or more serious ones, such as low blood pressure or difficulty breathing (shortness of breath).

In general, most side effects of Cialis are mild and may resolve on their own. They include:  

• Headaches

• Facial flushing

• Muscle aches

• Back pain

• Indigestion

• Nasal congestion

Some common side effects of Cialis, such as headaches, facial flushing, and nasal congestion, tend to be dose-dependent. Meaning, they typically get worse with higher doses. 

Taking too much Cialis can also raise your risk of experiencing  less common, but more severe, side effects such as:

• Dizziness

• Low blood pressure

• Chest pain 

• Shortness of breath

• Changes in vision (i.e. blurred vision or altered vision of colors)

• Hearing loss

• Priapism (any erection that lasts for more than four hours, often painful and always considered a medical emergency)

There is also a possibility of heart attack or stroke (mainly in people with pre-existing heart problems).

If you experience any of these severe side effects after taking Cialis, seek immediate medical attention. 

How much Cialis you can take depends on the dose prescribed by your healthcare provider. 

Based on factors such as your age, underlying health conditions, and the reason for prescribing Cialis, they’ll prescribe a Cialis dose either for daily or as-needed use. Sometimes, if your body is not responding to lower doses, your healthcare provider may adjust your dose as well. 

The maximum prescribed dose of Cialis you can take in a day for ED is 20 mg. 

The effects of Cialis last for about 36 hours in the body, so it’s not recommended to take more than one dose per day. It usually starts working in about 30 minutes, but in some people it can take up to 2 hours.

Here are the typical dosages for Cialis when prescribed for ED, BPH, or both:

• For daily treatment of ED: 2.5 mg or 5 mg once daily

• For as-needed treatment of ED: 5 mg, 10 mg, or 20 mg as needed before sexual activity (not more than once per day)

• For treatment of BPH or BPH with ED: 5 mg once daily

It’s important to share your medication list with your healthcare provider because Cialis has several important drug interactions. This can influence the dose of Cialis that your healthcare provider prescribes. Combining Cialis with certain medications can also make adverse effects more likely.

Significant Cialis drug interactions that can increase the risk of side effects include:

• Nitrates (e.g. nitroglycerin, which is sometimes used for chest pain)

• Guanylate cyclase stimulators (e.g. riociguat, which can be used for pulmonary hypertension)

• Alpha-blockers (which are sometimes used for prostate issues)

• Antihypertensives (blood pressure medicines)

• CYP3A4 inhibitors (medications such as certain HIV medications, antifungals, or antibiotics, which can affect how your body processes ED medications)

• Other PDE5 inhibitors (e.g. Viagra, which is why you should never combine ED medications unless explicitly told to do so by a healthcare provider under close monitoring)

To be on the safe side, always tell your healthcare provider what medications you are taking and keep them updated if there are any changes to your medication list. 

If Cialis isn’t working for you, your healthcare provider may recommend other options you can try to help with ED. These include other phosphodiesterase-5 (PDE5) inhibitors, as well as non-medication options. In some cases, your healthcare provider may also work with you to adjust the dosage or the timing of your medication.

ED medications and pills that can be alternatives to Cialis include prescription medications and other formulations featuring PDE5 inhibitors:

• Viagra (sildenafil) is a widely used prescription medication for ED that lasts for up to 4–6 hours.

• Vardenafil is a prescription medicine that starts working in about 30–60 minutes and lasts for about 4–6 hours; it’s less affected by taking the dose with a high-fat meal (some other PDE5 inhibitors, like Viagra, are more significantly affected).

• Stendra (avanafil)is the fastest PDE5 inhibitor available, as it can start working within 15 minutes; it lasts for up to five hours.

• Ro Sparks contains 55 mg sildenafil and 22 mg tadalafil in a dissolvable lozenge, intended to provide a fast onset and long duration.

• Daily Rise Gummies contain 7 mg tadalafil in a chewable formulation as a daily option for increased spontaneity.

*The last two medications are compounded medications and are therefore not specifically FDA-approved for ED. However, their active ingredients have been individually FDA-approved for the treatment of ED.

Making lifestyle changes or using devices are other alternatives to Cialis for ED. These methods include: 

• Regularly exercising

• Eating a balanced diet 

• Improving communication with your partner

• Lowering stress

• Reducing alcohol intake

Devices such as vacuum erection devices (penis pumps), shockwave therapy, and (for severe, refractory ED), penile implants are also non-medication options that can help with ED. Some people find that penile rings can also help facilitate erections hard enough for sex.

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Taking Cialis as prescribed by your healthcare provider is safest, and you should never try increasing your dosage on your own. This can result in a Cialis overdose and potentially severe side effects. Let’s review:

• A Cialis overdose happens when you take too much of the medication. While you may not always have severe symptoms from a Cialis or tadalafil overdose, taking too much of the drug increases the risk of side effects.

• Common side effects that can worsen from a Cialis overdose include headaches, facial flushing, and muscle aches. Serious side effects like low blood pressure or chest pain, changes in vision or hearing, and priapism are also possible. If experiencing serious side effects, don’t hesitate to  seek emergency medical attention.

• Typical Cialis dosages for ED are 2.5 mg–5 mg when used daily and 5 mg–20 mg when used as needed. However, your recommended dosage may differ depending on individualized guidance from your healthcare provider. 

• You should never take more than one dose of Cialis in a day. Each dose can last for up to 36 hours in your system.