Cialis (Tadalafil): Uses, Dosage, Side Effects and Cost in Canada

Cialis is the brand name for tadalafil, a prescription tablet for erectile dysfunction and enlarged prostate. Learn about doses, side effects, cost and how to ask a BC doctor.

sexual healthDoctor-reviewedPrescriptionAvailable in Canada
Illustration of a blister strip of tablets for Cialis (tadalafil)

Disclaimer: This article is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.

Overview

Cialis is the brand name for tadalafil, a prescription medicine made by Eli Lilly. It belongs to a group of medicines called PDE5 inhibitors, like sildenafil (Viagra).

Health Canada has authorized Cialis for erectile dysfunction (ED), for the signs and symptoms of benign prostatic hyperplasia (BPH, an enlarged prostate), and for both together. It comes as 2.5 mg and 5 mg tablets for once-daily use and 10 mg and 20 mg tablets for use as needed. Generic tadalafil contains the same medicine; see our tadalafil page for more.

Cialis needs a prescription. BC residents can speak with a BC-licensed doctor by phone through Avee Health to ask whether it is appropriate for them. The doctor decides based on your health history. A prescription is not guaranteed.

In Canada, Cialis is authorized for:

  • Erectile dysfunction in men, taken as needed or once a day
  • Signs and symptoms of benign prostatic hyperplasia (BPH), taken once a day
  • Erectile dysfunction and BPH together, taken once a day

Cialis is not for women or for anyone under 18, and it does not protect against sexually transmitted infections. Adcirca is a different tadalafil product used for pulmonary arterial hypertension, with a different dose.

Generic name

Tadalafil

Drug class

PDE5 inhibitor

Category

sexual health

Availability

Prescription required

In Canada

Available

How Cialis Works

During sexual arousal, the body releases a chemical that relaxes the blood vessels in the penis so more blood can flow in. Tadalafil blocks the enzyme PDE5, which normally breaks this signal down. The result is better blood flow and an easier erection.

Cialis works only with sexual stimulation and does not increase sex drive. In BPH, relaxing smooth muscle in the prostate and bladder area may ease urinary symptoms.

Dosage Instructions of Cialis

Your doctor sets your dose. The usual doses in the Canadian product monograph are:

  • ED, as needed: 20 mg before sexual activity, no more than once a day. The doctor may adjust it based on how well it works and how you tolerate it.
  • ED, once daily: 5 mg at about the same time each day, whether or not you plan sexual activity. It may be lowered to 2.5 mg.
  • BPH, or ED and BPH together: 5 mg once a day

Swallow the tablet with or without food. Never take more than one dose a day. If you have kidney or liver problems, tell your doctor: as-needed doses are started lower and taken less often, and once-daily use is not recommended for people with severe kidney or liver problems.

Missed once-daily dose: ask your pharmacist what to do, and do not take two doses in one day.

Storage Instructions

Store Cialis at room temperature, between 15°C and 30°C. Keep it out of the reach of children.

Side Effects of Cialis

In clinical trials of as-needed use for ED, the most common side effects were (Cialis compared with placebo):

  • Headache: 11%, compared with 4%
  • Indigestion: 7%, compared with 1%
  • Back pain, muscle aches, stuffy nose and flushing: about 4% each

Side effects were less common with the lower once-daily doses. Get medical help right away if you have:

  • An erection that lasts 4 hours or longer. Without prompt treatment it can damage the penis.
  • Sudden loss or decrease of vision in one or both eyes
  • Sudden decrease or loss of hearing, with or without ringing in the ears or dizziness
  • Chest pain, fainting or severe dizziness. Call 911 and tell the emergency staff you take Cialis, because nitrate medicines must not be given with it.
  • Signs of a serious allergic reaction, such as a rash, swelling of the face or trouble breathing

Important Safety Information About Cialis

  • Nitrates: do not take Cialis if you use any nitrate medicine, such as nitroglycerin. The combination can cause a life-threatening drop in blood pressure. If a nitrate is needed in an emergency, at least 48 hours should pass after the last Cialis dose before one is considered.
  • Riociguat and other guanylate cyclase stimulators: do not combine them with Cialis.
  • Vision: do not take Cialis if you have ever had non-arteritic anterior ischemic optic neuropathy (NAION), a cause of sudden vision loss in one eye.
  • Heart and blood vessels: sex puts extra strain on the heart. Cialis was not studied in people with a heart attack in the past 90 days, unstable angina, heart failure, a stroke in the past 6 months, uncontrolled heart rhythm problems, low blood pressure or uncontrolled high blood pressure. Tell the doctor about any heart condition.
  • Allergy: do not take Cialis if you are allergic to tadalafil or any ingredient. The tablets contain lactose.
  • Women and children: Cialis is not for women or for anyone under 18.
  • Products sold online: buy Cialis or tadalafil only from a licensed pharmacy with a prescription.

Drug Interactions

Tell your doctor and pharmacist about everything you take, including non-prescription products. The main interactions are:

  • Nitrates and riociguat: must not be combined with Cialis
  • Alpha-blockers, such as doxazosin: blood pressure can drop further. Cialis is not recommended together with an alpha-blocker for BPH.
  • Ketoconazole and ritonavir: raise tadalafil levels, so a lower or less frequent dose is used
  • Rifampin: lowers tadalafil levels, so it may work less well
  • Alcohol: both alcohol and tadalafil can lower blood pressure. Some people had dizziness on standing after a large amount of alcohol with tadalafil.
  • Other ED medicines, such as sildenafil: do not combine them with Cialis.

Brands & DIN Number of Cialis

Brand Names

Cialis

Key Takeaways

  • 1Cialis is the brand name for tadalafil, made by Eli Lilly. It is a PDE5 inhibitor and needs a prescription in Canada.
  • 2It is authorized for erectile dysfunction, an enlarged prostate (BPH), or both together.
  • 3For ED it can be taken as needed (usually 20 mg) or once a day (5 mg, or 2.5 mg).
  • 4Never take Cialis with nitrates such as nitroglycerin, or with riociguat.
  • 5Headache, indigestion, back pain and muscle aches are the most common side effects.
  • 6Generic tadalafil contains the same medicine. Ask your pharmacist about price differences.
  • 7BC residents can ask a BC-licensed doctor by phone whether Cialis is right for them. A prescription is not guaranteed.

Frequently Asked Questions

Is Cialis the same as tadalafil?
Yes. Cialis is the brand name and tadalafil is the medicine in it. Generic tadalafil tablets contain the same medicinal ingredient, though their colour, shape and non-medicinal ingredients can differ.
How much does Cialis cost in Canada?
The price depends on the strength, the number of tablets, the pharmacy, whether you choose brand or generic, and your coverage. Ask your pharmacist for current prices of both.
Does BC PharmaCare cover Cialis?
Coverage depends on what it is prescribed for, your PharmaCare plan and any private insurance, and the rules change. Check with your pharmacist, BC PharmaCare or your insurer.
How do I get Cialis in BC?
Cialis needs a prescription. You can see your family doctor, or book a phone visit with a BC-licensed doctor through Avee Health. Visits are covered by MSP with a valid BC health card. The doctor reviews your health history and decides whether Cialis is appropriate. A prescription is not guaranteed. If one is written, it is sent to the pharmacy you choose.
What is the difference between daily Cialis and as-needed Cialis?
As-needed Cialis is usually 20 mg taken before sexual activity, no more than once a day. Daily Cialis is a lower dose, usually 5 mg, taken at about the same time every day whether or not you plan sex. The daily dose is also used for BPH. Your doctor helps decide which suits you.
What is the difference between Cialis and Viagra?
Both are PDE5 inhibitors for erectile dysfunction, and both must never be taken with nitrates. Cialis contains tadalafil and can be taken as needed or once a day; it is also authorized for BPH. Viagra contains sildenafil and is taken as needed. They should not be taken together.
Can I drink alcohol with Cialis?
Both alcohol and tadalafil can lower blood pressure. In studies, some people had dizziness on standing after drinking a large amount of alcohol with tadalafil. Ask your doctor or pharmacist what is safe for you.
Can women take Cialis?
No. Cialis is not authorized for women in Canada and has not been studied in pregnant women.
Written By
Avee Editorial

Avee Editorial

Avee Editorial Team