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Last updated: Apr 15, 2021
5 min read

How to get the maximum effect from Cialis

Cialis (generic name tadalafil) is a popular drug for erectile dysfunction (ED). You can take it either 30 minutes to 1 hour before sexual activity, or once daily, regardless of when you have sex. For the best effects from the drug, it’s essential to take Cialis as directed by your healthcare provider and moderate your alcohol consumption.

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Reviewed by Felix Gussone, MD

Written by Cale Li, MD

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.

Cialis (generic name tadalafil; see Important Safety Information) is a prescription drug used to treat erectile dysfunction (ED). It is part of a group of medicines called PDE5 inhibitors. This group also includes sildenafil (brand name Viagra; see Important Safety Information). 

PDE5 inhibitor drugs work by increasing blood flow to the penis during arousal, making it easier to get an erection. Cialis doesn’t create spontaneous erections on its own and still depends on you to be in the mood for sex (Smith-Harrison, 2016). One of the benefits of Cialis is how long it lasts. It can be effective for up to 36 hours, allowing for spontaneity in your sex life when you take a smaller dose daily, regardless of when you have sex. 

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Find a dosing schedule that works best for you

There are two ways to take the medication: a lower dose daily, or a higher dose as-needed (Rew, 2016):

  • As needed: ideally at least 30 minutes before sexual activity.
  • Every day: taken at the same time each day without regard to when you have sex

Research has shown that both regimens are equally effective in treating erectile dysfunction (Brock, 2016). 

You and your healthcare provider can decide what works best for your sex life. With the as-needed regimen, you don’t have to take the medication every day, but it also means planning your sexual activities. The continuous regimen with a lower dose taken daily allows more flexibility and spontaneity in your sex life. You can just take the tablet every day at the same time and not have to worry about when sex is about to happen. 

These substances can interact with Cialis

Cialis is a safe and effective treatment for erectile dysfunction when taken as directed. But there are some drug interactions to be aware of. Talk to your healthcare provider if you have questions about your medications or supplements interacting with one another. 

Nitrates (Nitroglycerin)

When combined with nitrates (such as nitroglycerin), a medication used to treat episodes of chest pain in people with heart disease, PDE5 inhibitors like Cialis can cause your blood pressure to drop to low levels (FDA, 2011). 

Nitrites

For a similar reason, avoid amyl nitrite (more commonly known as “poppers”) when taking Cialis and other PDE5 inhibitors. Nitrites—with an “i”—like nitrates—with an “a”—cause muscle relaxation and dilation of blood vessels, which, when combined with Cialis, can cause your blood pressure to drop (Giorgetti, 2017). 

Alcohol

As Shakespeare wrote about booze in Macbeth, “it [alcohol] provokes the desire, but it takes away the performance.” While effective at lowering inhibitions, alcohol is a central nervous system depressant, and this can interfere with your ability to get an erection. It shouldn’t come as a surprise that people who drink alcohol regularly or in high amounts are more likely to experience erectile dysfunction (Wang, 2018). 

The makers of Cialis warn that combining the ED drug with “too much” alcohol may cause side effects (Eli Lilly and Company, 2013). They define “too much” as five glasses of wine or five shots of whiskey, which shows you that it’s more about moderation on drinking, not total abstinence. 

When combining alcohol and Cialis, common side effects are headache, facial flushing, and chest pain (Kim, 2019). Also, drinking large quantities of alcohol can lower your blood pressure while taking Cialis (Schwartz, 2010). 

Grapefruit juice

Some studies suggest that grapefruit juice could interact with the way your body metabolizes certain medications, causing higher levels of a drug than intended, including Cialis and other PDE5 inhibitors (Bailey, 2013; Shen, 2020). 

What if Cialis still isn’t working for me?

If you’re not satisfied with Cialis, a simple adjustment in dose and timing might be all you need. You should always speak to your healthcare provider before making any changes. Sometimes, the dosage or dosing schedule of a PDE5 inhibitor is not the main issue, especially when underlying health conditions cause or contribute to erectile dysfunction. Some medical conditions that can cause erectile dysfunction include (Rew, 2016):

Treating these underlying health conditions may help improve your erectile dysfunction as well. And for a natural boost to your sexual function, there are some lifestyle changes that can make a difference. 

Men who smoked cigarettes had higher rates of erectile dysfunction; those who quit smoking had improved erectile function (Kovac, 2015). Diet and exercise can also improve sexual function. Vigorous aerobic exercise can help improve erections (Silva, 2017). 

Summary: Cialis is an effective treatment for erectile dysfunction. For the best Cialis effects, it’s crucial to take the drug as directed, avoid substances like alcohol that can interfere with your erection, and incorporate lifestyle changes like smoking cessation and exercise.  

References

  1. Bailey, D. G., Dresser, G., & Arnold, J. M. (2013). Grapefruit-medication interactions: forbidden fruit or avoidable consequences?. CMAJ : Canadian Medical Association Journal, 185(4), 309–316. doi: 10.1503/cmaj.120951. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23184849/
  2. Brock, G., Ni, X., Oelke, M., Mulhall, J., Rosenberg, M., Seftel, A., D’Souza, D., & Barry, J. (2016). Efficacy of Continuous Dosing of Tadalafil Once Daily vs Tadalafil On Demand in Clinical Subgroups of Men With Erectile Dysfunction: A Descriptive Comparison Using the Integrated Tadalafil Databases. The Journal of Sexual Medicine, 13(5), 860–875. doi: 10.1016/j.jsxm.2016.02.171. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27114197/
  3. Eli Lilly and Company. (2013, July 16). New Study Shows Men Taking Cialis® (tadalafil) Tablets Once Daily Returned to Normal Erectile Function after Incomplete Response to As-Needed PDE5 Inhibitor Therapy. Retrieved June 18, 2020, from https://investor.lilly.com/news-releases/news-release-details/new-study-shows-men-taking-cialisr-tadalafil-tablets-once-daily
  4. Food and Drug Administration (FDA). (2007). Viagra (sildenafil citrate) tablets. Retrieved on Mar 30, 2021 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/020895s027lbl.pdf
  5. Giorgetti, R., Tagliabracci, A., Schifano, F., Zaami, S., Marinelli, E., & Busardò, F. P. (2017). When “Chems” Meet Sex: A Rising Phenomenon Called “ChemSex”. Current Neuropharmacology, 15(5), 762–770. doi: 10.2174/1570159X15666161117151148. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771052/
  6. Gong, B., Ma, M., Xie, W., Yang, X., Huang, Y., Sun, T., Luo, Y., & Huang, J. (2017). Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. International Urology and Nephrology, 49(10), 1731–1740. doi: 10.1007/s11255-017-1644-5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603624/
  7. Kim, J. N., Oh, J. J., Park, D. S., Hong, Y. K., & Yu, Y. D. (2019). Influence of Alcohol on Phosphodiesterase 5 inhibitors Use in Middle- to Old-Aged Men: A Comparative Study of Adverse Events. Sexual Medicine, 7(4), 425–432. doi: 10.1016/j.esxm.2019.07.004. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963111/
  8. Kovac, J. R., Labbate, C., Ramasamy, R., Tang, D., & Lipshultz, L. I. (2015). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087–1092. doi: 10.1111/and.12393. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25557907/
  9. Mykoniatis, I., Grammatikopoulou, M. G., Bouras, E., Karampasi, E., Tsionga, A., Kogias, A., Vakalopoulos, I., Haidich, A. B., & Chourdakis, M. (2018). Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction. The Journal of Sexual Medicine, 15(2), 176–182. doi: 10.1016/j.jsxm.2017.12.008. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29325831/
  10. Rew, K. T., & Heidelbaugh, J. J. (2016). Erectile Dysfunction. American Family Physician, 94(10), 820–827. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27929275/
  11. Schwartz, B. G., & Kloner, R. A. (2010). Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension. Circulation, 122(1), 88–95. doi: 10.1161/CIRCULATIONAHA.110.944603. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20606131/
  12. Shen, X., Chen, F., Wang, F., Huang, P., & Luo, W. (2020). The Effect of Grapefruit Juice on the Pharmacokinetics of Tadalafil in Rats. BioMed Research International, 2020, 1631735. doi: 10.1155/2020/1631735. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003282/
  13. Silva, A. B., Sousa, N., Azevedo, L. F., & Martins, C. (2017). Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis. British Journal of Sports Medicine, 51(19), 1419–1424. doi: 10.1136/bjsports-2016-096418. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27707739/
  14. Wang, X. M., Bai, Y. J., Yang, Y. B., Li, J. H., Tang, Y., & Han, P. (2018). Alcohol intake and risk of erectile dysfunction: a dose-response meta-analysis of observational studies. International Journal of Impotence Research, 30(6), 342–351. doi: 10.1038/s41443-018-0022-x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30232467/