Daily Cialis: benefits, dosage, side effects

There’s good news for the estimated 30–50 million American men who experience erectile dysfunction (ED)—there’s no shortage of effective treatments available (Sooriyamoorthy, 2022). If you struggle with getting or maintaining an erection strong enough for satisfying sex, you’ve likely heard about some of the most common medical treatments, like Viagra and Cialis, which are taken as needed, 30 minutes to an hour before sex. But daily Cialis is another option worth considering. 

Keep reading to learn about daily Cialis and whether it could be right for you. 

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Daily Cialis is the same medication as on-demand Cialis (generic name tadalafil); it’s just a lower dose that you take—you guessed it—on a daily basis. 

Cialis, like Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil) is a type of drug called a PDE-5 inhibitor. PDE-5 inhibitors improve erections by relaxing the smooth muscles, allowing increased blood flow to the penis (Dhaliwal, 2022).

While Cialis works the same way as other PDE-5 inhibitors, it lasts longer in the body than the other medications. For example, a standard dose of Viagra typically lasts 6–8 hours, while a standard dose of Cialis can last 36 hours. Because Cialis takes longer to leave the body, it can help men achieve erections (with sexual stimulation) for a full 24 hours between doses if taken daily at a lower dose (DailyMed, 2022).

Daily use Cialis comes in a tablet and is formulated to be taken at the same time each day. 

Treatments beyond ED

Daily low-dose Cialis has other medical uses. It’s FDA-approved to treat the symptoms of benign prostatic hyperplasia, known as BPH. This is a very common condition as men age, where the prostate grows and puts pressure on the urethra, the tube that carries urine from the bladder to the penis. When the prostate enlarges, it can cause urinary symptoms, such as having to pee often. Low-dose Cialis may help symptoms of BPH by relaxing the bladder and prostate muscles, making it easier to drain urine (Peixoto, 2015; Dhaliwal, 2022). 

Tadalafil under the brand name Adcirca is also FDA approved to treat high blood pressure in the lungs—a condition called pulmonary arterial hypertension (PAH) (FDA, 2015). 

Like Viagra, some healthcare providers may use Cialis “off-label” to treat Raynaud’s syndrome. Caused by the constriction of small arteries, Raynaud’s syndrome can cause fingers and toes to feel cold, numb, and turn white. Low-dose PDE-5 inhibitors like tadalafil may help improve blood flow (Musa, 2022). 

When deciding how to treat your erectile dysfunction, it’s important to get medical advice from your healthcare provider about which approach is best for you. This will depend on any health conditions you may have and how much sex you plan to have. 

If the goal is to have sexual activity multiple times a week and you aren’t sure when you’ll want to be ready for sex, daily Cialis may be a good option. Some of the advantages of daily Cialis include:

1. More spontaneous sex

Because men with ED take low-dose Cialis at the same time each day, there is no pressure to time medications and sex, which allows for increased spontaneity. This is an advantage if you are not sure when you’ll want to have sex and are having sex several times a week. 

2. Improvements in BPH symptoms

It’s estimated that more than 70% of men who have symptomatic BPH also have ED. Low-dose Cialis is FDA-approved to treat both conditions, so if you have both, you could be killing two birds with one stone. To treat BPH, a daily dose of 5 mg is recommended (DailyMed, 2022).

3. Alternative when on-demand ED pills aren’t working

Even though ED medications are quite effective, they don’t always work. Up to 35% of men with ED don’t respond to on-demand medications. Several studies have shown that daily, low-dose tadalafil may help improve erections when on-demand PDE-5 inhibitors are not effective (Jiang, 2018; Bolat, 2018).

Daily Cialis doses are usually 2.5 milligrams (mg) or 5 mg tablets, whereas the on-demand Cialis regimens typically range from 10 mg to 20 mg (DailyMed, 2022).

The FDA’s suggested dosing instructions for daily Cialis are based on what it’s being used for. For treating ED, the FDA recommends starting with 2.5 mg of Cialis, taken at approximately the same time every day, regardless of when sexual activity may take place. This once-daily dose may be increased to 5 mg, depending on how well it's working and any side effects (DailyMed, 2022).

Standard on-demand doses of both Viagra and Cialis typically start working within an hour of taking the medication if a man is sexually aroused. Daily low-dose Cialis is not fast-acting and can take 1–5 days to start working. Once it has built up in the system, daily doses keep enough of the medication in the system to allow for improved erections if there is sexual stimulation and arousal (Zucchi, 2019; Jiang, 2018).

The side effects of Cialis are usually mild when they occur. Studies show that men who take lower-dose daily Cialis typically have fewer or milder side effects than those who take higher doses. However, if they occur, these milder symptoms may last longer since the medication remains in the body (Washington, 2010). 

The most common side effects of the daily regimen include (DailyMed, 2022):

• Headache 

• Indigestion 

• Facial flushing

• Nasal congestion 

• Back pain 

• Muscle pain

• Cough 

While most side effects are mild if they occur, PDE-5 inhibitors have the potential for more serious side effects, especially if combined with other medications or with certain medical conditions. Some of these more serious side effects include (DailyMed, 2022):

• Low blood pressure (hypotension): PDE-5 inhibitors widen blood vessels and lower blood pressure. If you’re taking other medications that lower blood pressure or drink more than five alcoholic drinks a day, it could result in a dangerous drop in blood pressure, with symptoms such as dizziness and loss of consciousness. 

• Priapism: Priapism is a prolonged erection lasting four hours or more. While rare, an erection that lasts more than 4–6 hours is a medical emergency. If the erection continues, blood gets trapped and cuts off oxygen, which can lead to permanent tissue damage.

• Vision problems: Rarely, PDE-5 inhibitors may cause blurry vision due to an eye condition called non-arteritic ischemic optic neuropathy (NAION). 

• Hearing loss: There are rare reports of sudden hearing loss after starting Cialis; this may be accompanied by ringing in the ears (tinnitus).

• Bleeding: Cialis may affect blood platelets (cells that make your blood clot), which could increase the risk of prolonged bleeding.

There are some people with underlying health conditions or risk factors who may be advised to avoid PDE-5 inhibitors. It’s important to always check with a healthcare provider to review your health status, the medications and supplements you’re taking, and other potential risk factors. The following risk factors may prevent the use of Cialis (DailyMed, 2022):

• A history of heart problems, including chest pain (angina), irregular heartbeats, heart attack, or a stroke

• High or low blood pressure

• The use of nitrates, nitrites (including nitrite poppers), alpha-blockers, or other blood pressure medications

• A history of stomach ulcers

• Heavy alcohol consumption (which can lead to low blood pressure)

• An eye condition called retinitis pigmentosa

• Kidney or liver disease

In general, you should avoid combining different PDE-5 inhibitors since it increases the risk of priapism and other side effects. However, studies show there are some men with moderate to severe ED who may benefit from the use of daily Cialis combined with an on-demand medication like Viagra (Sullivan, 2021).

It’s important to work with your healthcare provider when evaluating ED treatments and determining any potential medical conditions that could be causing your ED. In many cases, treating an underlying health condition or identifying a medication that may be causing ED can be a first step toward finding solutions.

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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

December 01, 2022

Written by

Kristin DeJohn

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.