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Health Guide / Viagra/sildenafil

How long does Viagra last, and when does it start to work?

chimene richalinnea zielinski

Reviewed by Chimene Richa, MD, written by Linnea Zielinski

Last updated: Sep 02, 2022
8 min read

table of contents

  1. How long does Viagra last?
  2. What factors affect how long Viagra lasts?
  3. How long does Viagra take to work?
  4. When to take Viagra and how to take it
  5. How much Viagra should you take?
  6. Before and after Viagra
  7. Viagra side effects
  8. Risk factors and warnings
  9. Drug interactions with Viagra
  10. Alternatives to Viagra
  11. When to see a healthcare provider
  12. Viagra FAQs

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Erectile dysfunction (ED)—when a person experiences trouble getting or maintaining an erection—can be stressful, and worrying about how long Viagra lasts will not help the situation. Typically, Viagra—a medication healthcare providers prescribe to treat ED—lasts for about 4–5 hours, but because erectile dysfunction is so common, affecting 30–50 million people in the US, this time frame is not one-size-fits-all. Several factors can come into play to determine both how long Viagra takes to work and how long it lasts (Sooriyamoorthy, 2022). 

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How long does Viagra last?

It’s important to remember that you don’t need to have an erection for Viagra (see Important Safety Information) to work. Viagra’s active ingredient is sildenafil citrate, a PDE-5 inhibitor that relaxes muscles in the penis and improves blood flow to enable people with penises to have erections. It is neither required nor healthy to have an erection the entire time Viagra is in your system (Smith, 2022).

Viagra can stay active in your system for up to 4–5 hours, depending on other factors. Most healthcare providers suggest you take it 30–60 minutes before engaging in sexual activity, but you can take it up to four hours before intercourse. Some of the medicine may be in your body longer, but in concentrations too low to cause any effect (Zucchi, 2019; DailyMed, 2017). 

Many different factors affect how long Viagra works for someone, including the dose of the medication, other medications or supplements you’re taking, your age, diet, overall health, and psychological state.

What factors affect how long Viagra lasts?

A few major factors can affect how long Viagra will last after you take it.

Dosage

The amount of Viagra you take affects the way it works with your system and how long it stays in your body. Taking a higher dose, such as the largest available 100 mg tablet, may result in a longer-lasting effect than ingesting a smaller dose (Smith, 2022). Note: Consult your physician to ensure you’re taking the safest amount of Viagra for you, depending on your personal health circumstances.

Age

The effects of Viagra tend to last longer for older men over 65. This is because age comes with a slower metabolism process (DailyMed, 2017). Hence, Viagra can remain in your system, staying active for longer. Typically, it can last up to four hours, with your liver taking more time to metabolize the drug.

Food and overall diet

Eating heavily right before Viagra intake can considerably slow down the absorption of the drug and, in turn, delay its desired effects. Fatty foods can decrease drug absorption and increase how long sildenafil takes to start working—meaning taking sildenafil on an empty stomach may allow it to work faster. While this does not mean that you should deprive yourself of meals, you should consider waiting at least an hour after eating before taking Viagra to allow it to have the fullest effect (Zucchi, 2019).

Alcohol

It is most advisable to refrain from consuming alcohol when you’re taking Viagra. If it can’t be avoided, it is best to veer from excessive drinking. Drinking alcoholic beverages while taking Viagra has not been shown to cause adverse effects. However, alcohol can negatively impact the male reproductive system as a whole (Emanuele, n.d).

Medications

Certain medications should not be taken alongside Viagra. Interactions between Viagra and other medicines may change the expected results from the former. In addition, this may also cause more serious health complications (DailyMed, 2017). 

How long does Viagra take to work?

Viagra starts working in as little as 30 minutes after taking it. But it can take up to two hours to be effective if you take the drug with a big meal (Zucchi, 2019).

So, how does it work? A lot has to go right in your body for an erection to happen. Even if we ignore the mental and emotional aspects of arousal and how they can lower sex drive, an erection is a complicated physiological dance involving many systems of your body. 

A messenger called cGMP tells erectile tissue to relax, which allows blood to flow into the penis. But at the same time, the blood vessels that take the blood back to your heart constrict so that more blood is trapped in the penis. An enzyme called phosphodiesterase-5 (PDE-5) breaks down cGMP so that the erect penis can relax (Smith, 2022). 

That’s where Viagra comes in. Viagra is a PDE-5 inhibitor, which blocks this enzyme from breaking down the messenger that kick-starts the blood flow needed to get and maintain an erection (Smith, 2022). The medication doesn’t cause spontaneous erections on its own, though—it just makes them easier to form. You’ll still need to be sexually aroused to get an erection.

When to take Viagra and how to take it

Timing is essential when it comes to taking Viagra. The best time to take Viagra is about 30–60 minutes before sex for maximum effect. You can take Viagra with or without food, but know that high-fat mealsmay increase how long sildenafil takes to start working (Zucchi, 2019). 

If you think it is not working after 30–60 minutes, do not take more medication. There is an association between higher doses and higher rates of side effects. Talk to your healthcare provider if you feel like your Viagra or sildenafil is not working for you.

How much Viagra should you take?

Viagra (or generic Viagra) tablets typically come in three doses: 25 mg, 50 mg, and 100 mg. 

It’s most common for people to start with the 50 mg dosage. If you’re on a higher dose, the effects of Viagra may last longer. It may take more time for older people to eliminate Viagra from their bodies, meaning the medicine may last longer in their bodies. This may also be the case for people with medical conditions like liver or kidney disease (DailyMed, 2017).

Before and after Viagra

Wondering what to expect after taking Viagra?

Well, it won’t take effect right away. Viagra will begin to work around one hour after taking it. It needs this time to absorb into your blood completely. This is when Viagra reaches its peak concentration in your bloodstream and, thus, its optimal effect.

The drug will cause the blood vessels in the penis to relax, allowing increased blood flow to the organ and leading it to expand for an easier and stronger erection for a longer time.

A myth about Viagra is that it forces an erection. In fact, it does not, on its own, cause the erection. It assists with getting a full erection with proper sexual stimulation. When you are no longer turned on or sexually aroused, the erection should stop as normal.

Four hours after Viagra intake, the drug, now metabolized in the system, will reach its half-life (i.e., your blood is rid of half of the medication). This does not necessarily mean the effects are completely eradicated. Some people find that Viagra is still effective 18 hours after taking it (DailyMed, 2017; Smith, 2022).

After 24 hours, most of the sildenafil will leave the bloodstream, and the effects of the Viagra should subside (Smith, 2022). 

Viagra side effects

The most common side effects of Viagra include (Smith, 2022):

  • Headaches
  • Facial flushing
  • Indigestion/heartburn 
  • Back pain
  • Stuffy nose
  • Nausea 

Priapism, a persistent and painful erection that can last more than four hours, is the most infamous potential side effect of Viagra—fortunately, it is not a common one. But priapism is a serious health condition that requires immediate medical attention. You should follow medical advice on your recommended dose of Viagra and not take more if it doesn’t work in 30 minutes (Smith, 2022). 

Other serious side effects that are less common include (Smith, 2022):

  • Hearing loss (which can be sudden)
  • Irregular heartbeat
  • Severe low blood pressure
  • Blurred vision or vision loss, which can be in one or both eyes

Risk factors and warnings

Some medical conditions can interact negatively with Viagra. If you have any of the following, speak with your healthcare provider before taking Viagra. 

Blood pressure issues

Viagra relaxes the muscles of your blood vessels to improve blood flow. However, this can also cause low blood pressure. If your blood pressure drops too low, you can develop hypotension and may experience fainting, dizziness, etc. You should not take Viagra if you already have low blood pressure, as Viagra may worsen the condition.  

Similarly, if you have high blood pressure and use medications to lower it (antihypertensives), taking Viagra can cause your blood pressure to drop even further. This is especially true if you are taking an alpha-blocker antihypertensive, like terazosin. Alpha-blockers like tamsulosin (brand name Flomax) are also used to treat prostate issues and can have the same low blood pressure effect if taken with Viagra (DailyMed, 2017). 

Heart problems

People with heart conditions, such as a history of heart disease, heart failure, or those who’ve suffered recent chest pains or a heart attack, should check with their healthcare provider before taking Viagra (DailyMed, 2017). 

Vision concerns

Viagra may increase your risk of vision loss due to non-arteritic ischemic optic neuropathy (NAION), essentially a small stroke of the optic nerve. If you have a history of or risk factors for NAION, you should use caution with Viagra. Viagra has also been reported to cause changes in color vision in some people (DailyMed, 2017).

Lastly, anyone with an allergy or hypersensitivity reaction to Viagra should not use the medication.

Drug interactions with Viagra

Before starting Viagra or sildenafil, be sure to tell your healthcare provider about any other prescription drugs you are taking to avoid potential drug interactions. Some drugs, in particular, include:

  • Nitrates: Viagra is contraindicated if you are also taking nitrates (e.g., nitroglycerin) for chest pain. The combination of these two drugs can make your blood pressure drop to life-threateningly low levels. You need to wait at least 24 hours after taking Viagra before you can safely take nitrates (Smith, 2022). 
  • Ritonavir: Ritonavir affects the CYP3A4 enzyme in the liver—this is the system responsible for breaking down sildenafil. If taken with Viagra, ritonavir may raise Viagra concentrations in your blood and increase your risk of side effects like low blood pressure and prolonged erections (DailyMed, 2017).  
  • PDE-5 inhibitors: You should not combine sildenafil with other PDE-5 inhibitors (like Revatio for pulmonary arterial hypertension) or other erectile dysfunction treatments, to avoid the potential risk of a drop in blood pressure (DailyMed, 2017).

Alternatives to Viagra

Common alternatives to Viagra include Cialis (tadalafil; see Important Safety Information) and Levitra (vardenafil). If taking a pill before sexual activity doesn’t work for you, daily Cialis may be an option. Taken daily, this medication provides a low dose of tadalafil to be ready for sex anytime. Levitra acts similarly to Viagra and, like the blue pill, needs to be taken within a specific timeframe before sexual activity (Zucchi, 2019).

When to see a healthcare provider

In some cases, erectile dysfunction is due to underlying causes. Treating those conditions may help resolve the problem without ED medications. In other cases, performance anxiety may be the cause of erectile dysfunction. Addressing the mental and emotional aspects of sexual stimulation may also help. Your healthcare provider can help you navigate the different ED causes and the risks and benefits of various treatment options.

If you already take Viagra, seek medical advice from your healthcare provider if you feel that the medicine is not working for you. 

Viagra FAQs

Many people have questions about Viagra before or after starting the medication. Here are answers to some common questions. 

What is Viagra?

Viagra is a brand name for sildenafil. This medication is also used to help with erectile dysfunction (ED). 

How long do you stay hard with Viagra? 

With adequate sexual stimulation, Viagra can help a person stay hard for up to four hours.

How long does it take for Viagra to peak?

Viagra should begin to work within 30 minutes after a person takes it. However, it will reach its peak after 60 to 120 minutes. 

How much Viagra should I take the first time?

The recommended starting dose of Viagra is 50 mg. 

References

  1. DailyMed. (2017). Viagra – sildenafil citrate tablet, film-coated. Retrieved on Aug. 14, 2022 from https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a2a9f459-e692-4e85-83b0-a35fbf35e91b 
  2. Emanuele, M. A. & Emanuele, N. (n.d.). Alcohol and the male reproductive system. National Institute on Alcohol Abuse and Alcoholism. Retrieved on Aug. 14, 2022 from https://pubs.niaaa.nih.gov/publications/arh25-4/282-287.htm 
  3. Smith, B. P. & Babos, M. (2022). Sildenafil. StatPearls. Retrieved on Aug. 14, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK558978/  
  4. Sooriyamoorthy, T. & Leslie, S. W. (2022).  Erectile dysfunction. StatPearls. Retrieved on Aug. 14, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK562253/ 
  5. Zucchi, A., Costantini, E., Scroppo, F. I., et al. (2019). The first-generation phosphodiesterase 5 inhibitors and their pharmacokinetic issue. Andrology, 7(6), 804–817. doi:10.1111/andr.12683. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31350821/ 
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chimene richa
Chimene Richa, MD

Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.

Related articles

Important Safety Information for Sildenafil (Viagra)

What are the most important things I need to know about VIAGRA® (sildenafil citrate) 25 mg, 50 mg, and 100 mg tablets and generic VIAGRA®?

Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate emergency medical attention.

  • VIAGRA® and generic VIAGRA® can cause serious side effects. Serious, but rare, side effects include:
    • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, seek emergency medical attention right away. If it is not treated right away, priapism can permanently damage your penis.
    • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss
    • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away
  • VIAGRA® does not protect against sexually transmitted diseases, including HIV.

Who should not take VIAGRA® or generic VIAGRA®? 

Do not take VIAGRA® or generic VIAGRA® if you:

  • Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
  • Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®, or any of the ingredients in VIAGRA® or generic VIAGRA® tablets.
  • Are a women or a child

When should I call my primary provider? 

Call your primary provider right away if you:

  • Have an erection that lasts longer than 4 hours
  • Experience a sudden loss of vision in one or both eyes
  • Experience a sudden decrease in or loss of hearing
  • Experience chest pain, dizziness, or nausea during sex
  • Take too much Viagra or sildenafil citrate 

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

What are the most common side effects of VIAGRA® and generic VIAGRA®?

The most common side effects are:

  • headache
  • flushing
  • upset stomach
  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
  • stuffy or runny nose
  • back pain
  • muscle pain
  • nausea
  • dizziness
  • rash

What should I tell my Roman-affiliated provider before taking VIAGRA® and generic VIAGRA®?

Before you take VIAGRA® or generic VIAGRA® , tell your healthcare provider if you:

  • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • Have had heart surgery within the last 6 months
  • Have pulmonary hypertension
  • Have had a stroke
  • Have low blood pressure, or high blood pressure that is not controlled
  • Have a deformed penis shape
  • Have had an erection that lasted for more than 4 hours
  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • Have ever had severe vision loss, including an eye problem called NAION
  • Have bleeding problems
  • Have or have had stomach or intestinal ulcers
  • Have liver problems
  • Have kidney problems or are having kidney dialysis
  • Have any other medical conditions 

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects.

Especially tell your healthcare provider if you take any of the following:

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • Other medicines or treatments for ED
  • VIAGRA® contains sildenafil, which is the same medicine found in another drug called REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What is the FDA-approved use of VIAGRA® and generic VIAGRA®?

VIAGRA® (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED). 

Roman-affiliated doctors may prescribe VIAGRA® or generic VIAGRA® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment. While this is not an FDA-approved use of the drug, the American Urological Association has included the use of sildenafil citrate in the treatment of PE in its Guideline on the Pharmacologic Management of Premature Ejaculation.  

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see the full Prescribing Information for complete safety information. 

Product names referenced herein are trademarks of their respective owners.

Important Safety Information for Tadalafil (Cialis)

What Is The Most Important Information I Should Know About CIALIS® (tadalafil) and generic CIALIS®? 

  • CIALIS® and generic CIALIS® can cause serious side effects. Serious, but rare, side effects include:
    • An erection that won’t go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections. 
    • Changes in vision. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green. 
    • Sudden decrease or loss of vision. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS® and generic CIALIS®) reported a sudden decrease or loss of vision in one or both eyes. It is uncertain whether PDE5 inhibitors directly cause the vision loss. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS® and generic CIALIS®, and call a healthcare provider right away. 
    • Sudden loss or decrease in hearing. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS® and generic CIALIS®. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS® and generic CIALIS® and contact a healthcare provider right away. 
  • CIALIS® and generic CIALIS® can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke. 
  • Never take CIALIS® or generic CIALIS® with any nitrate or guanylate cyclase stimulator medicines. Do not take CIALIS® or generic CIALIS® if you take any medicines called “nitrates.” Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm. Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. 
  • Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrite and butyl nitrite. 
  • Do not take CIALIS® or generic CIALIS® if you take medicines called guanylate cyclase stimulators which include: Riociguat (Adempas®) a medicine that treats pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (pulmonary hypertension due to chronic blood clots in the lungs). Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are nitrates or guanylate cyclase stimulators, such as riociguat. 
  • Tell all of your healthcare providers that you take CIALIS® or generic CIALIS®. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took CIALIS® or generic CIALIS®. After taking a single tablet, some of the active ingredient of CIALIS® or generic CIALIS® remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications. 
  • Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. 
  • CIALIS® and generic CIALIS® for the Treatment of erectile dysfunction (ED): 
    • ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him.
    • CIALIS® and generic CIALIS® help increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Some form of sexual stimulation is needed for an erection to happen with CIALIS® or generic CIALIS®. 
    • CIALIS® and generic CIALIS® do not: 
      • Cure ED 
      • Increase a man’s sexual desire 
      • Protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases. 
      • Serve as a male form of birth control 
    • Do not use CIALIS® or generic CIALIS® with other ED medications.
  • CIALIS® and generic CIALIS® are only for men over the age of 18, including men with diabetes or who have undergone prostatectomy. 
  • CIALIS® and generic CIALIS® are not for women or children. 
  • CIALIS® and generic CIALIS® must be used only under a healthcare provider’s care. 
    • Take CIALIS® or generic CIALIS® exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Do not change your dose or the way you take CIALIS® or generic CIALIS® without talking to your healthcare provider.

Who Should Not Take CIALIS® or generic CIALIS®? 

Do not take CIALIS® or generic CIALIS® if you:

  • Have severe liver disease. Tell your doctor if you have mild to moderate liver disease as you may need dosage reductions.
  • Have severe kidney disease. Tell your doctor if you have mild to moderate kidney disease as you may need dosage reductions
  • Take any medicines called “nitrates” 
  • Use recreational drugs called “poppers” like amyl nitrite and butyl nitrite 
  • Take any medicines called guanylate cyclase stimulators, such as riociguat 
  • Are allergic to CIALIS®, tadalafil or ADCIRCA®, or any of its ingredients

When should I call my primary provider?

Call your primary provider right away if you: 

  • Have an erection that lasts longer than 4 hours
  • Experience a sudden loss of vision in one or both of your eyes
  • Experience a sudden decrease or loss hearing
  • Take too much CIALIS® or generic CIALIS® 
  • Have an allergic reaction to CIALIS® or generic CIALIS®
  • Symptoms of an allergic reaction may include: 
  • Rash 
  • Hives 
  • Swelling of the lips, tongue, or throat 
  • Difficulty breathing or swallowing 

Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above. 

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

What Should I Tell My Roman-affiliated Provider Before Taking CIALIS® and generic CIALIS®? 

Tell your Roman-affiliated provider about all your medical problems, including if you:

  • Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems. 
  • Have pulmonary hypertension
  • Have low blood pressure or have high blood pressure that is not controlled 
  • Have had a stroke 
  • Have liver problems 
  • Have kidney problems or require dialysis 
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease 
  • Have ever had severe vision loss, including a condition called NAION 
  • Have stomach or intestinal ulcers 
  • Have a bleeding problem 
  • Have a deformed penis shape or Peyronie’s disease 
  • Have had an erection that lasted more than 4 hours 
  • Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia 

Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. 

Especially tell your healthcare provider if you take any of the following: 

  • Medicines called nitrates 
  • Medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension 
  • Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), 4 Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS® or generic CIALIS® is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
  • Other medicines to treat high blood pressure (hypertension) 
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir® , Kaletra® )
  • Oral antifungals such as ketoconazole (Nizoral® ), itraconazole (Sporanox® ) 
  • Antibiotics such as clarithromycin (Biaxin® ), telithromycin (Ketek® ), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine). 
  • Other medicines or treatments for ED. 
  • Tadalafil is also marketed as ADCIRCA® for the treatment of pulmonary arterial hypertension. Do not take both CIALIS® or generic CIALIS® and ADCIRCA®. Do not take sildenafil citrate (Revatio®, Viagra®) with CIALIS® or generic CIALIS®. 

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most common side effects of CIALIS® or generic CIALIS®?

The most common side effects with CIALIS® and generic CIALIS® are:

  • Headache
  • Indigestion
  • Back pain
  • Muscle aches
  • Flushing
  • Stuffy or runny nose

What is the FDA-approved Use of CIALIS® and generic CIALIS®? 

CIALIS® and generic CIALIS® are prescription medicines used to treat erectile dysfunction (ED), symptoms of benign  prostatic hyperplasia (BPH), or both.

Roman-affiliated doctors may prescribe CIALIS® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.  

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see the full Prescribing Information for complete safety information.